The patient is in need of immediate hemodialysis, but has no vascular access. The nurse prepares the patient for insertion of:
a. a percutaneous catheter at the bedside.
b. a percutaneous tunneled catheter at the bedside.
c. an arteriovenous fistula.
d. an arteriovenous graft.
A
Temporary percutaneous catheters are commonly used in patients with acute kidney injury because they can be used immediately. Occasionally a percutaneous tunneled catheter is placed if the patient needs ongoing hemodialysis; however, these catheters are usually inserted in the operating room. An arteriovenous fistula is an internal, surgically created communication between an artery and a vein. This method produces a vessel that is easy to cannulate but requires 4 to 6 weeks before it is mature enough to use. Arteriovenous grafts are created by using different types of prosthetic material, most commonly polytetrafluoroethylene and Teflon. Grafts are placed under the skin and are surgically anastomosed between an artery and a vein. The graft site usually heals within 2 to 4 weeks.
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