Question

A client with end-stage kidney disease (ESKD) undergoes a surgical procedure to create an arteriovenous fistula for hemodialysis in the upper extremity. The nurse should take which actions when the client returns from surgery? Select all that apply.

1.Monitor pain and administer analgesics.
2.Monitor bleeding and swelling at the site.
3.Monitor for circulation above the fistula site. 4.Measure the blood pressure in the arm every hour. 5.Check for audible bruit and palpable thrill at the fistula site.

Answer 1

After a surgical procedure to create an arteriovenous fistula for hemodialysis, the nurse should monitor pain, bleeding, swelling, circulation, and check for audible bruit and palpable thrill at the fistula site.

Step-by-step explanation:

When a client with end-stage kidney disease undergoes a surgical procedure to create an arteriovenous fistula for hemodialysis in the upper extremity, the nurse should take several actions when the client returns from surgery. These actions include:

1. Monitoring pain and administering analgesics: It is important to assess the client's pain level and manage it effectively with appropriate analgesics.
2. Monitoring bleeding and swelling at the site: The nurse should regularly assess the surgical site for any signs of bleeding or swelling, which may indicate complications.
3. Monitoring for circulation above the fistula site: The nurse should assess the circulation above the fistula site to ensure proper blood flow and detect any signs of compromised circulation.
4. Measuring the blood pressure in the arm every hour may not be necessary unless specifically ordered by the healthcare provider.
5. Checking for audible bruit and palpable thrill at the fistula site: The nurse should assess for the presence of an audible bruit (a humming sound) and a palpable thrill (a vibration) at the fistula site, which indicate that the fistula is functioning properly.