What nursing assessments are essential for a patient with an arteriovenous fistula?

An arteriovenous fistula, or AV fistula, is the preferred vascular access for hemodialysis, created by surgically connecting an artery to a vein in the forearm. The nurse must assess for a palpable thrill, which is a buzzing vibration felt over the fistula, and an audible bruit heard with a stethoscope, both confirming blood flow through the access. Never take blood pressure, draw blood, or start intravenous lines in the arm with the fistula. Report immediately if the thrill or bruit is absent, as this indicates clotting.