Today our topic of discussion is Post Procedure Care for Av.

Post Procedure Care for Av

Postprocedure Care for AV Fistula

Wash the hands and turn the blood pump of machine to 50-100 ml. per minute hemodialysis
Put on clean gloves; remove the tape from the connection site of arterial lines
Clamp the needle tubing with hemostat and disconnect the line
Blood in the arterial line will continue to flow towards the dialyzer followed by a column of air, just before the blood reaches the point where the saline solution enters the line clamp the blood line with another hemostat
Unclamp the saline solution and allow small amount to flow through the line
Unclamp the hemostat on machine line
After the blood is retransfused clamp the venous needle tubing and machine venous line with hemostat, turn off the blood pump
Remove the tape from the connection site of venous line and disconnect the lines
Remove the venous puncture needle and apply pressure with a folded gauze pad (4″ x 4″)
Apply adhesive bandage and repeat the procedure on the arterial line
When the procedure is complete check the patient’s weight and mental status
Compare the findings with redialysis assessment date
Document the findings
Disinfect and rinse the delivery system.

Role of Nurse in Care of Patient on Hemodialysis with AV Shunt

Remove the bull dog clamps and shunt the dressing and clean it using aseptic technique
Clean the bull dog clamp with alcohol sponge
Assemble the shunt adaptors
Clean the arterial and venous shunt, use separate sponge for each shunt and wipe in one direction from insertion site to connection site
Allow the tubing to air dry .
Put on sterile gloves
Clamp the arterial side of the shunt with bulldog clamp and also the venous site, when the shunt is open .
Open the shunt by separating its side with your finger.

Both side of the shunt should be exposed
Adapt the shunt to the lines of the machine.
Attach a shunt adapter and 10 mL syringe filled with 8 ml. of normal saline to the side of the shunt containing Teflon connector .
Attach a new Teflon connector to another side of the shunt with second adapter: attach it also with 10 mL syringe filled with 8 mL of normal saline to the same side
Next flush the shunt arterial tubing by releasing the clamp and aspirate the saline solution, and then flush the tubes slowly repeat the procedure on the venous side.
Secure the shunt to the adapter with the adhesive tape.
Connect the arterial and venous line to the adapter.

Postprocedure Care for AV

Wash the hands .
Turn the blood pump on the hemodialysis machine to 50-100 mL per minute.
Put sterile glove and remove the tape from the connection site of the arterial lines.
Clamp the arterial cannula with the bull dog clamp and then disconnect the lines.
Blood in the arterial line will continue to flow toward the dialyzer followed by a column of air, just before the blood reaches the point where the saline solution enters the line clamp the blood line with another hemostat .
Unclamp the saline solution and allow small amount to flow through the line .
Unclamp the hemostat on machine line, just before the last volume of blood enters the patient clamp the venous cannula with bull dog clamp and machines venous lines with hemostat.
Remove the tape from connection site of venous line.
Turn off the blood pump and disconnect the lines .
Reconnect the shunt cannula, remove older two Teflon connectors and discard, connect the shunt and take care that position of the Teflon connector is equal between the two cannulas.
Remove the bull dog clamps .
Secure the shunt connection with hypoallergenic tape .

Clean the shunt and the site with gauze pads soaked in povidone-iodine solution.
Make sure the blood flow through the shunt adequately .
Apply the dressing to the shunt site and wrap it securely with elastic gauze bandage .
Attach the bull dog clamps to the outside dressing.
When the hemostat is complete check the vital signs and the mental status.
Compare the findings with the predialysis assessment data.
Document the finding.
Disinfect and rinse the delivery system.

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