The nurse creates a care plan for a client receiving hemodialysis through an arteriovenous (AV) fistula in the right arm. The nurse will include which interventions to protect the AV fistula from injury? Select all that apply.

A. Instruct the client not to carry heavy objects or anything that compresses the extremity: Avoiding heavy lifting or compression protects the AV fistula from trauma or thrombosis, which could compromise its patency and effectiveness for hemodialysis. B. Avoid taking blood pressure or performing venipuncture in the extremity: Using the extremity for blood pressure measurements or venipuncture can cause vessel damage, clot formation, or infection, increasing the risk of fistula failure. C. Palpate for thrills and auscultate for a bruit every shift: Regular assessment of the thrill and bruit helps detect early signs of stenosis, thrombosis, or decreased blood flow, allowing prompt intervention to preserve fistula function. D. Check for bleeding and infection at hemodialysis needle insertion site: Monitoring the insertion site ensures early detection of infection or bleeding, which can compromise the fistula and the client’s overall safety during dialysis. E. Assess pulses and circulation proximal to the fistula: While monitoring distal circulation is important to assess for steal syndrome, evaluating pulses proximal to the fistula is not directly related to protecting the fistula itself from injury. F. Instruct the client not to sleep in a position that places her or his body weight on top of the extremity: Preventing pressure on the fistula during sleep reduces the risk of compression, thrombosis, or vessel damage, supporting long-term fistula patency.