July

Question Title

* Rotating needle sites over the entire length of the patient’s access may prevent

The correct answer is d. fistula failure.

Rationale: Avoid “area puncture,” which refers to cannulating in the same small areas over and over. This approach quickly damages a fistula. Aneurysms (weak spots in a vessel wall) often result, which can lead to loss of the access or, if they rupture, hemorrhage and possible death of the patient.

Reference: Medical Education Institute. (2018). Core Curriculum for the Dialysis Technician, 6th ed., pp. 162-163.
February

Question Title

* A patient who recently had an arteriovenous fistula placed in the left forearm develops steal syndrome. Which of these symptoms would the technician expect to observe in the patient’s left hand?

The correct answer is coldness.

Rationale: Steal syndrome is a problem that occurs when a fistula or graft “steals” too much blood away from the hand. The low blood flow (ischemia) causes a shortage of oxygen that can harm tissue.  Signs of steal syndrome include coldness, pain, numbness, and tingling in the affected hand.

Reference: Medical Education Institute. (2018). Core Curriculum for the Dialysis Technician, 6th ed., pp. 158, 359; Kallenbach, J. Z. (2016). Review of Hemodialysis for Nurses and Dialysis Personnel, 9th ed., p. 149.
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