The nurse is checking the patency of a new right arm arteriovenous fistula. What action does the nurse use to do this? Select all that apply
auscultate the right brachial pulse
palpate for thrill over the right arm fistula
measure the blood pressure in the right arm
auscultate the right radial pulse
auscultate bruit over the right arm fistula
palpate the right radial pulse
Correct Answer : B,E
A. Auscultating the brachial pulse is not typically used to assess the patency of an arteriovenous fistula.
B. A thrill is a vibration felt over an arteriovenous fistula or graft and indicates proper blood flow. Palpation for thrill is a standard method to assess fistula patency.
C. Blood pressure measurement does not directly assess the patency of an arteriovenous fistula.
D. Auscultating the radial pulse is not typically used to assess the patency of an arteriovenous fistula.
E. A bruit is a swooshing sound heard over an arteriovenous fistula or graft and indicates turbulent blood flow. Auscultating for bruit is another method to assess fistula patency.
F. Palpate the right radial pulse: Palpating the radial pulse is not typically used to assess the patency of an arteriovenous fistula.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Monitoring fluid intake and output provides direct measurement of fluid balance in the body.
B. Lung sounds may indicate fluid accumulation in the lungs but are not a direct measure of overall fluid balance.
C. Edema may indicate fluid retention but does not provide comprehensive information about fluid balance throughout the body.
D. While weight can be an indicator of fluid balance, it is influenced by factors other than fluid status, such as muscle mass and fat.
Correct Answer is ["A","B","C","D","E"]
Explanation
First, Hodgkin lymphoma (HL) is commonly characterized by painless lymphadenopathy and is not painful, as stated above. Secondly, HL is often characterized by a low-grade fever rather than a high fever. Third, the presence of Bence-Jones cells in a laboratory test is not associated with Hodgkin lymphoma but indicates multiple myeloma, a different type of cancer. Fourth, Hodgkin disease is indeed a form of cancer; it is a malignancy of the lymphatic system. The nurse's statement that it is "not really cancer" is incorrect and misleading. Fifth, palliative radiation therapy is typically used to relieve symptoms in advanced stages of cancer or non-curative scenarios. However, for stage 1 Hodgkin lymphoma, the treatment usually involves chemotherapy and/or radiation therapy with curative intent, not palliative. Joe's nurse should provide accurate information about the nature of Hodgkin's disease and its treatment options, which are based on the stage and specific characteristics of the lymphoma.
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