Final answer:
Proper postoperative nursing care for a patient with an arteriovenous fistula and shunt includes regularly checking the shunt positioning, monitoring for respiratory complications, ensuring no IV fluids are administered into the arm with the shunt, and avoiding blood pressure measurements on the extremity with the shunt.
Step-by-step explanation:
Postoperative nursing care for a patient who has an arteriovenous fistula and an external arteriovenous shunt for hemodialysis includes several critical interventions to prevent complications and ensure proper functioning of the access sites. Let's address the particular points listed in the question:
- Regularly check the positioning of the external shunt. The proper positioning ensures that blood flow is not obstructed, which is essential for the functioning of the shunt.
- Check for signs and symptoms of respiratory complications. This is a standard postoperative monitoring practice, although not specifically related to the shunt or fistula, complications like a pulmonary embolism could occur due to the nature of the surgery.
- Ensure that intravenous fluids are not infused in the arm with the shunt. Infusing fluids into the same arm can increase the risk of increasing pressure, which can compromise the shunt function.
- Covering the ends of the shunt cannula with a dressing is generally not recommended since it is important to monitor for signs of infection, bleeding, or other complications.
- Do not take blood pressure on the extremity with the shunt. This is to prevent any damage or undue stress to the shunt, which can lead to complications or failure of the vascular access.
These interventions contribute to the patient's overall safety and the longevity of the vascular access necessary for effective hemodialysis.