How would a nurse determine the patency of a fistula used for dialysis?

• A. Listen for bruit
• B. Palpate for warmth
• C. Measure BP over the arm
• D. Check for swelling

Answer: (A)

Assessing patency of a dialysis fistula is about confirming unobstructed flow through it. The best bedside indicator is listening for a bruit over the fistula—the whooshing sound created by blood moving through the access. A normal bruit means blood is flowing well and the fistula is patent; if the bruit is weak or absent, narrowing or blockage may be present and further evaluation is needed. Palpating for a thrill is another useful sign of patency, but auscultating for bruit is the most direct single test in this context. Avoid taking blood pressure in the arm with the fistula, as that can damage the access. Warmth or swelling can indicate infection or other issues, but they do not reliably reflect fistula patency.