Vascular Access Management Flashcards

Which type of vascular access is considered the gold standard for hemodialysis?

Answer: Arteriovenous fistula

The arteriovenous (AV) fistula is the gold standard for hemodialysis access due to its lower infection risk, longer patency, and better outcomes.

What is the recommended minimum maturation time for an AV fistula before first cannulation?

Answer: 6–8 weeks

An AV fistula should mature for at least 6–8 weeks before cannulation to allow adequate vessel dilation and wall thickening.

A patient's AV graft has a palpable thrill that becomes weaker than usual. What does this most likely indicate?

Answer: Thrombosis or stenosis

A weakened or absent thrill in an AV graft suggests reduced blood flow, most commonly caused by thrombosis or upstream/downstream stenosis.

Which cannulation technique involves rotating needle insertion sites along the entire length of the fistula?

Answer: Rope-ladder technique

The rope-ladder technique distributes needle punctures along the entire length of the access, reducing localized damage and aneurysm formation.

When assessing a tunneled hemodialysis catheter for infection, which finding requires immediate removal of the catheter?

Answer: Tunnel infection (purulent drainage along the tunnel)

A tunnel infection with purulent drainage along the subcutaneous catheter tract indicates deep infection requiring catheter removal and systemic antibiotics.

What is the correct response when a dialysis patient arrives with a non-tunneled temporary catheter and reports pain, swelling, and redness at the insertion site?

Answer: Notify the physician and withhold dialysis pending evaluation

Signs of catheter site infection require prompt physician notification and access evaluation before dialysis proceeds to prevent bacteremia.