The nurse is caring for a client who just had an arteriovenous (AV) fistula placed for dialysis. The nurse is providing home care instructions to the client. Which statement by the client indicates a need for further teaching by the nurse?

  1. “I should avoid wearing a watch on my arm with the fistula.”
  2. “It may take several weeks before the fistula is ready to use.”
  3. “I should not have my blood pressure taken in my access arm.”
  4. “I should wear tight sleeves to protect and support the fistula so I don’t bend it.”
Number 4 is correct.
Rationale: Clients with AV fistulas should avoid wearing tight sleeves or jewelry over the access area because restricting the blood flow may lead to clotting. A watch should be switched to the opposite arm. Fistulas take several weeks to mature to the point where they may be used. Blood pressures should not be taken in the arm with the fistula. The client should also not have needle sticks in the access arm.