Question

The patient just completed a vascular “mapping” procedure with an angiogram to plan the site of an AV fistula for hemodialysis. You are considering the care priorities for the patient’s return when the AV fistula is formed. What are important teaching points for the period immediately following AV fistula formation? The patient asks if there is anything she can do to make this AV fistula last a long time. How should you respond to promote best practices in AV fistula self-management? What else should this patient know about AV fistula care?

Answer 1

#. An abnormal connection or passageway between an artery and a vein.

It may be congenital, surgically created for hemodialysis treatments, or acquired due to pathologic process, such as trauma or erosion of an arterial aneurysm.

#. AV fistula care :-

- Inform patient that it will take 6weeks to get mature and ready for use.

- Assess patency of a long-term device arteriovenous (AV) fistula, or arteriovenous graft (presence of bruit, palpable thrill, distal pulses and circulation)

-avoid procedures using the arm with an access site

-elevate the extremity following surgical development of AV fistula to reduce swelling

- Blood pressure should NEVER be taken on the extremity that has the AV access site because it can cause collapse of the AV fistula or graft.

- Check BUN and creatinine .

- Assess the access site for bleeding because heparin is administered during the procedure to prevent clotting of blood with the dialyzing surfaces.