When providing care for a patient receiving a new permanent vascular access graft, what finding should be reported immediately to the surgeon?

The inability to palpate a thrill following the placement of a new permanent vascular access graft is a critical observation that should be reported immediately to the surgeon. The presence of a thrill signifies adequate blood flow through the graft and the successful vascular anastomosis. A thrill is the vibration felt over the graft, indicating that the blood is flowing effectively, which is essential for the graft to function properly.

When a patient is unable to palpate a thrill, it may suggest that there is inadequate blood flow, which could be due to several serious complications, such as thrombosis or kinking of the graft. These complications must be addressed promptly to prevent graft failure and preserve the patient’s access for future procedures. Therefore, this finding is considered urgent and warrants immediate evaluation by the surgeon to investigate and correct the problem.

While the presence of a thrill is a normal finding, increased pain and a drop in blood pressure can indicate other issues but are not as directly related to the immediate function and viability of the graft as the thrill's absence.