Which intervention does the nurse utilize post-operatively to assess the patency of the arteriovenous fistula?

Assess the fistula with a large bore needle

Auscultate the fistula site for a bruit.

Measure the blood pressure in the affected arm

Assess the rate and quality of the radial pulse on the affected arm

Answer and Explanation

The Correct Answer is B

A. Assess the fistula with a large bore needle: Large bore needles are used during dialysis sessions, not for routine assessment. Inappropriate needling can damage the fistula.

B. Auscultate the fistula site for a bruit: A functional AV fistula should have a palpable thrill (vibration) and an audible bruit (whooshing sound) when auscultated with a stethoscope. These findings confirm adequate blood flow and patency.

C. Measure the blood pressure in the affected arm: Blood pressure measurements should never be taken on the fistula arm to prevent compression and potential fistula failure.

D. Assess the rate and quality of the radial pulse on the affected arm: The radial pulse does not accurately assess AV fistula patency; the focus should be on the thrill and bruit.

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Correct Answer is D

Explanation

A. Diphenhydramine: An antihistamine used for motion sickness, but not first-line for severe nausea and dehydration.

B. Famotidine: A histamine-2 blocker used for acid reflux, not nausea control.

C. Omeprazole: A proton pump inhibitor for acid suppression, not for nausea and vomiting.

D. Ondansetron: Ondansetron (Zofran) is a serotonin (5-HT3) receptor antagonist that is highly effective for nausea and vomiting, especially in dehydration and severe vomiting.

A. BUN 45 mg/dL and creatinine 8 mg/dL B. BUN 10 mg/dL and creatinine 0.3 mg/dL C. BUN 8 mg/dL, and creatinine 0.7 mg/dL D. BUN 23 mg/dl and creatinine 1.0 mg/dL

Correct Answer is A

Explanation

A. BUN 45 mg/dL and creatinine 8 mg/dL: In CKD, BUN (> 20 mg/dL) and creatinine (> 1.2 mg/dL) are significantly elevated due to reduced kidney function. A creatinine of 8 mg/dL indicates severe renal impairment.

B. BUN 10 mg/dL and creatinine 0.3 mg/dL: Too low for CKD, suggestive of normal renal function.

C. BUN 8 mg/dL, creatinine 0.7 mg/dL: Normal values.

D. BUN 23 mg/dL, creatinine 1.0 mg/dL: Mild elevation, but not consistent with CKD severity.

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