A nurse is caring for a client who has a new arteriovenous (AV) graft in his left forearm. Which of the following techniques should the nurse use to assess the patency of this graft?

 

Choice A reason: While kidney infections can cause swelling, they typically do not lead to a significant increase in abdominal girth unless associated with severe obstruction or advanced kidney disease.

Choice B reason: In PKD, the kidneys can become significantly enlarged due to the growth of numerous cysts, which

can indeed lead to an increase in abdominal girth.

Choice C reason: While stones can cause blockage and swelling, they would not typically result in a generalized increase in abdominal girth unless there is an associated infection or severe obstruction.

Choice D reason: Inflammation can lead to fluid retention, but in the context of PKD, it is the cysts' growth that primarily contributes to increased kidney size and abdominal girth.

The correct answer is Choice A

Choice A rationale: Headache and restlessness can be signs of a seizure or neurological disturbance, which phenytoin is used to treat. Phenytoin is an anticonvulsant medication that helps control seizures by stabilizing neuronal membranes and reducing excitability.

Choice B rationale: Decreased blood pressure and rapid pulse are not indications for phenytoin administration. These symptoms may suggest hypotension or cardiovascular issues, which require different interventions such as fluid resuscitation or vasopressors.

Choice C rationale: Muscle cramps and chest heaviness are not treated with phenytoin. These symptoms could indicate electrolyte imbalances or cardiac issues, which need specific treatments like electrolyte replacement or cardiac monitoring.

Choice D rationale: Pain and tingling at the access site are not indications for phenytoin administration. These symptoms may suggest local irritation or infection at the dialysis access site, requiring appropriate wound care or antibiotics.