Dental OSCE (Objective Structured Clinical Examination) Practice Exam

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For patients on dialysis, where should blood pressure be measured?

  1. On the arm with the shunt

  2. On the arm opposite of the shunt

  3. On both arms simultaneously

  4. On the wrist

The correct answer is: On the arm opposite of the shunt

Blood pressure for patients on dialysis should be measured on the arm opposite of the shunt. This is because patients often have a dialysis access site, typically a fistula or graft, in one arm. Taking blood pressure on the same arm as the shunt can result in inaccurate readings and could potentially compromise the access site's integrity. The arm opposite to the shunt is unaffected by the access procedure and provides a more reliable measure of systemic blood pressure without the risk of damaging the shunt or causing complications related to that access point. Using the arm with the shunt could lead to complications like thrombosis, infection, or reduced blood flow to the site, while measuring on both arms simultaneously is generally unnecessary and impractical for routine assessments. Similarly, measuring the blood pressure on the wrist can also be inaccurate compared to upper arm readings due to variations in blood flow and position. Hence, the safest and most accurate practice is to measure blood pressure on the arm opposite the dialysis access.