A nurse is teaching a client undergoing hemodialysis about the importance of maintaining vascular access. Which statement by the client indicates a correct understanding of the teaching?
"I should avoid using the arm with the arteriovenous (AV) fistula for blood pressure measurements."
"I can use the AV fistula arm for intravenous catheter insertion."
"I should avoid performing self-cannulation of my AV graft."
"I can apply pressure to my AV fistula site if it starts bleeding."
The Correct Answer is A
A. Correct. Using the arm with the AV fistula for blood pressure measurements can compress the vascular access and compromise blood flow. It is important to avoid using the fistula arm for blood pressure measurements and venipuncture.
B. Incorrect. The AV fistula should not be used for intravenous catheter insertion to prevent potential damage and infection to the access site.
C. Incorrect. Self-cannulation of the AV graft is typically performed by healthcare professionals, and clients should not attempt to self-cannulate their vascular access.
D. Incorrect. If an AV fistula starts bleeding, the client should not apply pressure to the site. Instead, they should immediately elevate the arm and apply pressure to the bleeding site with a clean cloth or bandage while seeking medical attention.
QUESTIONS
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Related Questions
Correct Answer is C
Explanation
A) This statement is incorrect. Peritoneal dialysis does not use a machine to filter blood outside of the body; that description is characteristic of hemodialysis.
B) This statement is incorrect. Peritoneal dialysis does not involve the removal of the peritoneal membrane; instead, it uses the peritoneal membrane in the abdomen to filter waste.
C) This statement is accurate. Peritoneal dialysis uses the peritoneal membrane in the abdomen as a semipermeable membrane to filter waste products and excess fluids from the blood.
D) This statement is incorrect. Peritoneal dialysis does not require a catheter to be inserted into the bladder. Instead, it uses a catheter to infuse and drain dialysate into and out of the peritoneal cavity.
Correct Answer is D
Explanation
A) This statement is incorrect. Hypoglycemia (low blood glucose) is not the primary indication for initiating dialysis. Hypoglycemia can occur in certain situations, but it is not the primary concern in this case.
B) This statement is incorrect. Hyperkalemia (elevated potassium levels) can be a concern in AKI, but it is not the primary indication described in the scenario. The primary concern in AKI with decreased GFR is the impaired filtration and waste removal, leading to the need for dialysis.
C) This statement is incorrect. Hypernatremia (high sodium levels) is not a primary indication for initiating dialysis in AKI. Hypernatremia is rare in AKI and usually occurs when there is a significant loss of free water compared to sodium intake.
D) A significantly decreased glomerular filtration rate (GFR) indicates that the kidneys' ability to filter waste products and excess fluids from the blood is severely impaired. Dialysis can help support kidney function and remove waste products when the GFR is critically low.
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