Parents of a child who will need hemodialysis ask the nurse, "What are the advantages of a fistula over a graft or external access device for hemodialysis?" What response should the nurse give? (Select all that apply.)
a. It is ready to be used immediately.
b. There are fewer complications with a fistula.
c. There is less restriction of activity with a fistula.
d. It produces dilation and thickening of the superficial vessels.
e. The fistula does not require a needle insertion at each dialysis.
ANS: B, C, D
The creation of a subcutaneous (internal) arteriovenous fistula by anastomosing a segment of the radial artery and brachiocephalic vein produces dilation and thickening of the superficial vessels of the forearm to provide easy access for repeated venipuncture. Fewer complications and less restriction of activity are observed with the use of a fistula. Both the graft and the fistula require needle insertion at each dialysis. The fistula cannot be used immediately.
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