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October 2010, Volume 40 Number 10 , p 53 - 53


  • Jill Rushing MSN, RN


A PATIENT IN END-STAGE kidney disease relies on dialysis to mechanically remove fluid, electrolytes, and waste products from the blood. For the most effective hemodialysis, the patient needs good vascular access with an arteriovenous (AV) fistula or an AV graft that provides adequate blood flow. Follow your facility's policies and procedures and these clinical tips to protect and preserve the vascular access and avoid complications such as infection, stenosis, thrombosis, and hemorrhage: * Remove any restrictive clothing or jewelry from the arm. * To prevent injuries, place an armband on the patient or a sign over the bed that says no BP measurements, venipunctures, or injections on the affected side. When blood flow through the vascular access is reduced, it can clot. * Perform hand hygiene before you assess or touch the vascular access. If it's a new vascular access with a wound, don gloves. Position the patient's arm so the vascular access is easily visualized. * Assess

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