The nurse is caring for a patient receiving hemodialysis three times weekly. The patient has had surgery to form an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this patient?
A) Using a stethoscope for auscultating the fistula is contraindicated.
B) The patient feels best immediately after the dialysis treatment.
C) Taking a BP reading on the affected arm can damage the fistula.
D) The patient should not feel pain during initiation of dialysis.
Ans: C
Feedback:
When blood flow is reduced through the access for any reason (hypotension, application of BP cuff/tourniquet), the access site can clot. Auscultation of a bruit in the fistula is one way to determine patency. Typically, patients feel fatigued immediately after hemodialysis because of the rapid change in fluid and electrolyte status. Although the area over the fistula may have some decreased sensation, a needle stick is still painful.
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