A nurse is teaching a client with a new arteriovenous fistula for hemodialysis. Which instruction should the nurse include to protect the fistula?

Choice A reason: Wearing a wristwatch on the fistula arm can compress the vascular access, impairing blood flow and risking thrombosis or fistula failure. This could reduce dialysis efficacy or cause complications, so patients are advised to avoid constrictive items on the fistula arm to maintain patency. Choice B reason: Avoiding sleeping on the fistula arm prevents pressure that could obstruct blood flow, reducing the risk of thrombosis or damage to the arteriovenous fistula. Maintaining unobstructed flow is critical for effective hemodialysis, as compression can lead to clotting or fistula dysfunction, requiring surgical intervention. Choice C reason: Obtaining blood pressure from the fistula arm is contraindicated, as cuff pressure can damage the fistula or cause thrombosis. This disrupts vascular integrity, risking dialysis access failure. Blood pressure should be measured on the opposite arm to protect the fistula’s function and longevity. Choice D reason: Lifting heavy weights with the fistula arm risks trauma or increased pressure, potentially causing fistula rupture or thrombosis. Patients are advised to avoid heavy lifting to maintain fistula integrity, as excessive strain can impair blood flow, compromising dialysis effectiveness and leading to vascular complications.