The nurse is caring for a chronic renal failure client with an AV fistula. The client has just completed hemodialysis. Site care of the fistula would initially involve:
1. Application of firm pressure to the site.
2. Placing a sterile dressing over the site.
3. Checking the blood pressure in the extremity.
4. Applying antibiotic ointment to the site.
Application of firm pressure to the site.
Rationale: After the discontinuation of the dialysis needles that were placed into the artery and vein of the fistula, the client would be at risk for bleeding; firm pressure at the site should be applied until bleeding has stopped. The fistula will not require a dressing after the completion of hemodialysis. A blood pressure obtained in the extremity of the fistula could occlude the fistula. There is no need to apply antibiotic ointment to the site unless there are signs of infection present.
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