Hand and Arm Exercises for Chronic Kidney Disease Patients Undergoing Arteriovenous Fistula Surgery for Hemodialysis: Nurse’s Role
Keywords:
Hand and arm exercises, Arteriovenous fistula surgery, Nurse’s role, Chronic kidney patientsAbstract
End stage renal disease patients (ESRD) with hemodialysis (HD) treatment need to undergo arteriovenous fistula surgery (AVF) for long term HD and wait on the kidney transplantation (KT) list. AVF needs time for maturation and ESRD patients should be encouraged to follow hand-arm exercise programs pre-post AVF creation in order to cause significant outflow vein dilatation and increase vascular access (VA) flow and clinical maturation. However, hand-arm exercise programs vary depending on the clinical practice guideline of each hospital.
Nurses have a vital role to provide care and advice to persons with ESRD undergoing AVF for HD treatment. They also have to plan assessment and caring for ESRD pre-post AVF surgery such as observing signs of infection, bleeding and other complications. In addition, they need to advise on exercise techniques for persons with ESRD pre-post AVF surgery. This article provides current evidence-based practice in relation to types of vascular access, preemptive vascular access (VA), VA assessment before AVF surgery, and nurse’s role in hand and arm resistance exercises pre and post-AVF surgery. Therefore, nurses need to consider weight or resistance used individually, and types of equipment and duration of exercise appropriately in order to reduce complications post-AVF surgery as well as enable AVF maturation.
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