Final answer:
The nurse should ensure the patient moves the extremity with the vascular access site as little as possible, change the dressing over the site regularly, not use the site for infusion of IV fluids, and assess for a thrill or bruit over the site each shift.
Step-by-step explanation:
The nurse should include the action of ensuring that the patient moves the extremity with the vascular access site as little as possible in the plan of care for a patient with chronic kidney disease who is receiving hemodialysis on a scheduled basis. This is important to prevent complications and maintain the integrity of the vascular access site. Moving the extremity can cause trauma to the area, increasing the risk of infection or damage to the access.
The dressing over the vascular access site should be changed regularly according to the facility's policy, but not necessarily every 12 hours. The frequency of dressing changes depends on the specific patient's condition and the presence of any signs of infection.
The vascular access site should not be utilized for infusion of IV fluids. The site is specifically for dialysis and should not be used for any other purposes.
Assessing for a thrill or bruit over the vascular access site each shift is an important action to monitor the functionality of the access site. A thrill is a vibrating sensation that can be felt over the access site and indicates proper blood flow, while a bruit is a swishing sound that can be heard over the access site and also indicates proper blood flow.