A nurse is planning care for a client who is postoperative following creation of an arteriovenous fistula in the left arm. Which of the following actions should the nurse include in the plan?
Auscultate the client's left arm for a bruit every 4 hours.
Compare blood pressure in both arms every 2 hours.
Instruct the client to keep the left arm in a dependent position.
Encourage the client to restrict movement of the left arm.
The Correct Answer is A
A.
A. Auscultating the client's left arm for a bruit helps assess the patency and function of the arteriovenous fistula. A bruit indicates normal blood flow through the fistula.
B. Comparing blood pressure in both arms every 2 hours is not specifically related to monitoring the arteriovenous fistula. Blood pressure comparison may be done periodically but is not as directly relevant to postoperative care of the fistula.
C. Instructing the client to keep the left arm in a dependent position may help with venous return but is not the primary action for monitoring the arteriovenous fistula's patency and function.
D. Encouraging the client to restrict movement of the left arm is not necessary unless there are specific instructions from the surgeon. Encouraging gentle movement and range of motion exercises may actually be beneficial for preventing stiffness and promoting healing.
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Correct Answer is D
Explanation
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B. Lying down after meals can worsen symptoms of nausea and reflux. Remaining upright or sitting up after meals may help alleviate symptoms.
C. Drinking large amounts of water with meals may exacerbate feelings of fullness and contribute to nausea. Sipping small amounts of fluids between meals is recommended.
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Correct Answer is D
Explanation
- Choice A: The recommended hepatitis vaccine series is not a series of four. The Advisory Committee on Immunization Practices (ACIP) recommends a three-dose series for hepatitis B vaccination.
- Choice B: Hepatitis B is not typically transmitted by contaminated food. It is primarily spread through direct contact with infectious blood, semen, or other body fluids.
- Choice C: While there is some evidence suggesting a link between chronic hepatitis C infection and an increased risk of renal cell carcinoma, the statement is not universally accepted as fact and more research is needed to establish a definitive connection.
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