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Answer is B as if no thrill and no bruit then it's clotted. Heparin prevents but will not dissolve. Usually they have to go to special procedures for declot procedures and possible angioplasty to open it up. Some require further stenting interventions. If it's clotted they cant be dialyzed so no need to go there. Hope this helps :)
Notify the doc. I am a dialysis nurse and if the fistula or graft (they're not called shunts anymore) is clotted, it is useless. The pt must go to an access clinic right away to get declotted by a doc.
Heparin does not desolve clots- it prevents clots. Once anything is clotted off, heparin is useless.
Superlost1984
41 Posts
Hi everyone I am new here and just registered minutes ago. I am currently reviewing for my NCLEX and encountered this question. I am a bit confused as to what the best answer for this could be.
Well the question was about a patient with an AV shunt scheduled for hemodialysis that day. However, during assessment, the nurse couldn't palpate the thrill and couldn't hear the bruit. What should the nurse do?
a. keep shunt elevated above the level of the heart
b. Notify the physician
c. Flush with heparinized solution
d. Go on with the dialysis
I feel that it's C but I am tempted to answer B. Could you help me out?
This was one of the items in a practice test wherein there is no answer key.