The charge nurse is orienting a new nurse about care for an assigned client with an arteriovenous (AV) fistula for hemodialysis in her left arm. Which action by the float nurse would be considered unsafe?

Rationale: A. Checking distal pulses in the left arm is a safe and appropriate nursing action. It helps assess for adequate circulation beyond the AV fistula site and ensures that the vascular access has not compromised blood flow to the distal extremity. B. Using the right arm for a blood pressure reading is appropriate and safe. Blood pressure measurements, venipunctures, or IV insertions should never be done on the arm with the AV fistula to avoid causing clot formation, vessel damage, or access loss. C. Palpating the access site for a bruit or thrill is an important routine assessment to verify the patency and proper functioning of the fistula. The presence of a thrill (vibration) and bruit (swishing sound) indicates adequate blood flow through the access. D. Administering intravenous fluids through the AV fistula is unsafe and contraindicated. The AV fistula must be used only for hemodialysis by trained personnel. Using it for IV fluids or medications increases the risk of infection, thrombosis, or permanent damage to the access site, which could compromise future dialysis treatments.