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. Decreases the chance of peptic ulcer formation: Calcium carbonate is not an antiulcer medication.

B. Prevents constipation: Calcium carbonate can cause constipation, not prevent it.

C. Increases the tubular excretion of potassium: Calcium carbonate does not directly affect potassium excretion.

D. To lower phosphorus levels: Calcium carbonate is a phosphate binder that reduces phosphorus absorption from food. In chronic renal failure, phosphorus builds up due to decreased kidney excretion, leading to secondary hyperparathyroidism and bone disease (renal osteodystrophy).

A. Administer supplemental oxygen B. Secure precautions C. Cardiac monitoring D. Initiating a fluid restriction

Correct Answer is C

Explanation

A. Administer supplemental oxygen: Hypokalemia primarily affects cardiac and neuromuscular function, not oxygenation. Oxygen may be needed if dysrhythmias develop but is not the highest priority.

B. Seizure precautions: While severe hypokalemia can cause muscle weakness, seizures are not the primary concern. Cardiac effects take priority.

C. Cardiac monitoring: A potassium level of 2.2 mEq/L is critically low, increasing the risk of life-threatening cardiac arrhythmias. Continuous cardiac monitoring helps detect dangerous dysrhythmias like ventricular tachycardia.

D. Initiating a fluid restriction: Fluid restriction is more relevant for hyperkalemia or fluid overload, not hypokalemia.

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

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

Explanation

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