National Physical Therapy Examination (NPTE) Practice Exam

What is the best approach for monitoring blood pressure in a patient with chronic renal failure around dialysis sessions?

1. Every 10 minutes during activity, using the shunted arm

2. Before and after activities, using the non-shunted arm

3. In the supine position

4. Using a wrist monitor periodically during treatment

The correct answer is: Before and after activities, using the non-shunted arm

The best approach for monitoring blood pressure in a patient with chronic renal failure around dialysis sessions is to assess it before and after activities, using the non-shunted arm. This method is effective because it ensures that blood pressure measurements are taken in a controlled way, providing reliable data on the patient's hemodynamic status before they engage in activities and after any interventions, such as dialysis. Using the non-shunted arm is crucial because patients undergoing dialysis often have a vascular access (fistula or graft) in one arm, which is not suited for blood pressure measurement as it could risk damaging the access site. Monitoring blood pressure in the non-shunted arm helps avoid complications and ensures that the readings are more accurate and not influenced by the dialysis access. Measuring blood pressure before and after activities also allows healthcare providers to assess how physical activity or interventions may have impacted the patient's blood pressure, which can be crucial in managing their overall care. This approach fits well within the clinical guidelines for managing patients undergoing dialysis, as it balances patient safety with the need for effective monitoring. The other choices suggest approaches that could lead to unreliable or dangerous data. For instance, monitoring every 10 minutes during activity using the shunted arm could risk compromising the vascular access and might yield