Vascular Access and Cannulation Flashcards

What is the preferred vascular access type for chronic hemodialysis patients?

Answer: Arteriovenous fistula

The arteriovenous fistula (AVF) is the gold standard vascular access for hemodialysis due to its superior longevity and lower complication rates.

The 'buttonhole' or constant-site cannulation technique involves:

Answer: Inserting needles at the same site and angle each treatment

The buttonhole technique involves cannulating the exact same site at the same angle each treatment, creating a fibrous tract that reduces pain and aneurysm formation.

Which sign during fistula assessment indicates possible stenosis or outflow obstruction?

Answer: Pulsatile, hard-feeling access with high venous pressures

A pulsatile, hard-feeling access with elevated venous pressures during dialysis suggests downstream stenosis impeding blood flow.

When cannulating an AVF, the arterial needle should be inserted pointing in which direction relative to blood flow?

Answer: Retrograde or antegrade depending on facility protocol and access characteristics

Arterial needle direction (antegrade or retrograde) depends on facility protocol and individual access characteristics to optimize blood flow.

A patient's fistula has a bruit that is continuous and high-pitched throughout systole and diastole. This is:

Answer: Normal — indicates good blood flow through the access

A continuous, soft, low-pitched bruit heard throughout the cardiac cycle indicates a well-functioning AVF with adequate blood flow.

Which complication of AVF cannulation is characterized by blood tracking into surrounding tissue during needle insertion?

Answer: Infiltration/hematoma

Infiltration occurs when the needle is not properly seated in the vessel lumen, allowing blood to extravasate into surrounding tissue and form a hematoma.