CCHT Vascular Access 2

Question 1

What is the rope ladder cannulation technique, and what is its primary advantage for arteriovenous fistulas?

Accepted Answer

Rotating needle insertion sites along the entire fistula length to distribute vessel trauma and prevent aneurysm formation

Answer

A technique using multiple needles simultaneously for higher flow

Answer

Inserting needles at a 45-degree angle for deeper vessels

Answer

A technique using smaller gauge needles to reduce trauma

Question 2

What is the minimum maturation time typically required before a new arteriovenous fistula should be used for dialysis?

Accepted Answer

4 to 6 weeks minimum; ideally 3 to 4 months for optimal maturation

Answer

1 week after surgical creation

Answer

2 to 3 days after surgery

Answer

The fistula can be used immediately after surgery

Question 3

A patient with a forearm AVF complains of pain, numbness, and weakness in the hand during dialysis treatments. The hand is cold and pale. What complication is most likely occurring?

Accepted Answer

Distal access ischemia (steal syndrome) requiring surgical evaluation

Answer

Carpal tunnel syndrome from B2M deposits

Answer

Normal post-dialysis ischemia that resolves spontaneously

Answer

Hypocalcemia-induced muscle cramps

Question 4

Which of the following best describes the function of the outflow vein in an arteriovenous graft (AVG)?

Accepted Answer

The outflow vein carries high-pressure arterial blood away from the graft anastomosis toward the heart

Answer

The outflow vein carries dialyzed blood from the venous needle back to the patient

Answer

The outflow vein is used for the arterial needle placement

Answer

The outflow vein regulates access blood flow

Question 5

What is the appropriate gauge needle to use for hemodialysis cannulation in standard adult patients?

Accepted Answer

15 to 17 gauge needles are standard for most adult hemodialysis patients

Answer

18-gauge (largest diameter)

Answer

20 to 22 gauge needles to minimize vessel trauma

Answer

Gauge does not matter as long as blood flow is adequate

Question 6

When caring for a patient with a tunneled central venous catheter (TCC) used for hemodialysis, what is the primary advantage of the tunneled design over a non-tunneled catheter?

Accepted Answer

The subcutaneous tunnel and Dacron cuff reduce infection risk by creating a physical barrier to bacterial migration

Answer

Tunneled catheters allow higher blood flow rates

Answer

Tunneled catheters can be inserted at the bedside without imaging guidance

Answer

Tunneled catheters last only 2 to 4 weeks before requiring replacement