A patient receiving hemodialysis treatments has had surgery to form an arteriovenous fistula. Which of the following 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 blood pressure reading on the affected arm can cause clotting of the fistula.
D) The patient shouldn't feel pain during initiation of dialysis.
Ans: C
Feedback: Pressure on the fistula or on the extremity can decrease blood flow and precipitate clotting. 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, the needle stick is still painful.
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