مريض غسيل كلوي عنده ناسور شرياني وريدي في الذراع اليسرى. أي ملاحظة تحتاج إبلاغ الطبيب فوراً؟

A haemodialysis client has an arteriovenous fistula in the left arm. Which finding needs immediate report to the provider?

1. A continuous bruit heard with a stethoscope over the fistula
2. A strong thrill felt with fingers placed on the fistula
3. No palpable thrill and no audible bruit over the fistula
4. Mild warmth of the skin over the fistula site

Answer: C) No palpable thrill and no audible bruit over the fistula. A palpable thrill and audible bruit mean blood is flowing; their absence suggests the fistula has clotted, which needs urgent intervention to save it. Mild warmth is normal because of the high blood flow.