Vascular Access Management Flashcards

Which dressing change technique is used for the buttonhole cannulation method?

Answer: Removal of scab with sterile technique before needle insertion

In the buttonhole technique, the scab at the tract entrance must be removed using sterile technique before inserting the blunt needle to maintain tract integrity.

What is a primary advantage of the buttonhole cannulation technique over rope-ladder technique?

Answer: Reduced cannulation pain and fewer hematomas

Buttonhole cannulation uses blunt needles inserted into established tracts, significantly reducing pain and the risk of hematoma formation with each treatment.

A patient on hemodialysis has a Kt/V of 1.1 and a recirculation rate of 22% in their AV fistula. What is the most likely cause?

Answer: Access stenosis causing venous hypertension

High recirculation rates in an AV fistula typically indicate venous outflow stenosis, which causes treated blood to re-enter the arterial needle before reaching systemic circulation.

Which sign is the BEST indicator of AV graft thrombosis?

Answer: Absence of bruit and thrill

Loss of the bruit (audible sound) and thrill (palpable vibration) over an AV graft is the most reliable clinical indicator of thrombosis.

What should the dialysis nurse do first when a patient experiences venous needle dislodgement during treatment?

Answer: Immediately turn off the blood pump and apply firm pressure to the site

Venous needle dislodgement requires immediately stopping the blood pump and applying firm pressure to prevent significant blood loss.

Which intervention is recommended to prevent steal syndrome in a patient with an AV fistula?

Answer: Surgical banding or revision of the fistula

Steal syndrome (ischemia distal to the AV fistula) is managed surgically through banding or revision to reduce blood diversion from the distal extremity.