Vascular Access and Cannulation Flashcards
6 cards from real CHT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Vascular Access and Cannulation flashcards as text
A patient reports arm pain distal to the fistula during and after dialysis, with cold fingers. This is most consistent with:
Answer: Access-related ischemic mononeuropathy (steal syndrome)
Pain and coldness distal to an AVF or graft suggests vascular steal syndrome where the access diverts blood from the distal limb.
When using a tunneled hemodialysis catheter, the recommended locking solution placed in the catheter lumens between treatments is:
Answer: Heparin (1000-5000 units/mL) or citrate locking solution
Catheter lumens are locked with heparin or citrate solution between treatments to prevent fibrin occlusion and maintain catheter patency.
Elevated venous pressure during hemodialysis (above 250 mmHg at a 400 mL/min flow rate) most likely indicates:
Answer: Venous stenosis or outflow obstruction
Persistently high venous pressures suggest stenosis or obstruction downstream from the venous needle impeding blood return to the patient.
The minimum recommended blood flow rate for adequate hemodialysis in most adult patients is:
Answer: 300-400 mL/min
Blood flow rates of 300-400 mL/min are recommended to achieve adequate solute clearance (Kt/V ≥1.2) in standard hemodialysis.
When recirculation in a dialysis access is suspected, which test can confirm it?
Answer: Glucose step test or urea-based recirculation test
The glucose step test or urea-based recirculation measurement quantifies the percentage of dialyzed blood re-entering the arterial needle rather than returning to the patient.
An AV fistula thrill that is absent on palpation and a bruit that is absent on auscultation most likely indicates:
Answer: Access thrombosis
Loss of palpable thrill and audible bruit in a previously functioning AVF is a classic sign of thrombosis requiring urgent intervention.