Vascular Access Management Flashcards

A patient's AV fistula has a bruit that has changed from soft and continuous to harsh and high-pitched. This change suggests:

Answer: Development of a stenosis in the access

A change to a harsh, high-pitched bruit indicates turbulent flow through a narrowed area, suggesting stenosis requiring evaluation.

When applying post-dialysis compression to an AV fistula site, how long should pressure typically be maintained?

Answer: 5–10 minutes

Pressure should be applied for 5–10 minutes after needle removal to achieve hemostasis without occluding the fistula.

Which AV graft material is most commonly used for hemodialysis access today?

Answer: Expanded polytetrafluoroethylene (ePTFE)

Expanded PTFE (Gore-Tex) is the most widely used synthetic graft material due to its durability and biocompatibility.

What does 'dynamic venous pressure monitoring' during dialysis help detect?

Answer: Outflow stenosis in the venous segment of an access

Elevated dynamic venous pressures over multiple treatments indicate outflow stenosis, which can be confirmed with access flow studies or fistulogram.

A tunneled dialysis catheter is locked with which solution between dialysis sessions to maintain patency?

Answer: Heparin or citrate locking solution

Heparin or citrate locking solutions fill the catheter lumens between sessions to prevent thrombus formation and maintain patency.

Which complication is characterized by swelling of the entire arm on the side of an AV access?

Answer: Central venous stenosis

Central venous stenosis obstructs venous return from the entire arm, causing diffuse swelling, particularly common with prior subclavian catheter placement.