What should the PACU nurse monitor to assess the functionality of a new dialysis graft?

To assess the functionality of a new dialysis graft effectively, monitoring for a palpable thrill and audible bruit is critical. A palpable thrill refers to the vibration felt over the graft when blood flows through it, indicating that the graft is patent and blood is moving properly. Similarly, an audible bruit, which is a whooshing sound heard with a stethoscope over the graft site, also signifies that blood is flowing adequately through the graft.

These assessments are crucial because they provide immediate, tangible evidence that the graft is functioning as intended, which is vital for the patient's dialysis needs. If either of these findings is absent, it may signal a problem with the graft, such as thrombosis or stenosis, requiring prompt medical evaluation.

While skin temperature and color, capillary refill time, and urine output may provide insights into a patient's overall circulatory status and kidney function, they are not specific indicators of the efficacy or patency of the dialysis graft itself. Thus, monitoring for a palpable thrill and audible bruit gives the most direct assessment of the graft's performance.