The patient in the progressive care unit following arteriovenous fistula implantation in his left upper arm, and is due to have blood drawn with his next set of vital signs and assessment. When the nurse assesses the patient, what should he/she do?

Rationale: A. Drawing blood from the left arm is incorrect because venipuncture or IV insertion should be avoided in the arm with a newly created arteriovenous (AV) fistula. Puncturing the fistula can damage it, compromise future dialysis access, and increase the risk of infection or thrombosis. B. Auscultating for a bruit and palpating for a thrill is correct because this is the standard assessment to ensure AV fistula patency. A thrill is a palpable vibration over the fistula, and a bruit is a whooshing sound heard with a stethoscope. Monitoring these ensures the fistula is functioning properly for future hemodialysis. C. Taking blood pressure from the left arm every 4 hours is incorrect because blood pressure should never be taken on the arm with a fistula, as it can cause trauma, clotting, or compromise blood flow to the fistula. The right arm or another site should be used. D. Starting a new intravenous line in the left lower arm is incorrect because IV access should ideally be placed in the opposite arm or another site to preserve the fistula for dialysis access.