Free Vascular Access Questions and Answers

Question 1

What are the three main types of vascular access used in hemodialysis?

Accepted Answer

Arteriovenous fistula, AV graft, and central venous catheter

Answer

The three main types of vascular access used in hemodialysis are the arteriovenous (AV) fistula, the AV graft, and the central venous catheter. An AV fistula is a surgical connection between an artery and a vein, an AV graft uses a synthetic tube to connect them, and a central venous catheter is a tube inserted into a large central vein. Each type has distinct advantages and disadvantages for long-term or temporary use.

Question 2

Which vascular access is considered the gold standard for long-term dialysis?

Accepted Answer

AV fistula

Answer

The arteriovenous (AV) fistula is considered the 'gold standard' for long-term hemodialysis access due to its superior outcomes. It has lower rates of infection and thrombosis, longer patency, and provides better blood flow compared to AV grafts and central venous catheters. It is formed by surgically connecting a patient's own artery and vein, allowing it to mature and strengthen over time.

Question 3

Why should blood pressure and venipuncture be avoided in the arm with an AV fistula?

Accepted Answer

To avoid damaging the fistula

Answer

Blood pressure measurements and venipuncture should be avoided in the arm with an AV fistula to prevent damage to the delicate vascular access. Compressing or puncturing the fistula can lead to thrombosis, infection, or loss of patency, which would compromise the patient's ability to receive life-sustaining dialysis treatments. Preserving the fistula's integrity is paramount.

Question 4

What is the correct method to assess an AV fistula?

Accepted Answer

Palpate for thrill and listen for bruit

Answer

Assessing an AV fistula involves both palpation and auscultation to confirm its patency and function. A 'thrill' is a palpable vibration felt over the fistula, indicating blood flow, and a 'bruit' is a whooshing sound heard with a stethoscope, also confirming adequate blood flow. The presence of a strong thrill and bruit indicates a healthy, functioning fistula.

Question 5

How is a central venous catheter typically placed for dialysis?

Accepted Answer

Inserted into the internal jugular vein and tunneled

Answer

A central venous catheter for dialysis is typically inserted into a large central vein, most commonly the internal jugular vein in the neck. For long-term use, a portion of the catheter is then tunneled under the skin before exiting, which helps to reduce the risk of infection by creating a barrier and stabilizing the catheter.

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT - Certified Clinical Hemodialysis Technician Practice Test

Free Vascular Access Questions and Answers