What should be listened for during the assessment of an internal access?

During the assessment of an internal access, listening for a bruit is critical because it indicates adequate blood flow through the access. A bruit is an abnormal sound caused by turbulent blood flow, which is often detected using a stethoscope over an arteriovenous (AV) fistula or graft. The presence of a bruit signifies that the access is functioning properly and that there is sufficient arterial blood flow to the dialyzer, which is essential for effective dialysis treatment.

In a clinical context, assessing the bruit can also aid in detecting complications such as thrombosis or stenosis, where the vascular access might be compromised. A strong, easily audible bruit suggests good patency of the access, while a diminished or absent bruit could indicate potential issues that need to be evaluated further.

Other sounds, such as vascular sounds or friction rubs, are not typically used in the context of assessing AV access. Whispering sounds also do not hold significance in this type of examination and are unrelated to vascular assessments. Thus, focusing on the bruit is crucial for confirming the functionality of the internal access.