Why should the nurse encourage ROM exercises in an extremity with an AV fistula?

Encouraging range of motion (ROM) exercises in an extremity with an arteriovenous (AV) fistula primarily serves to maintain muscle strength. When a fistula is created for hemodialysis, the fistula itself can alter the normal blood flow and muscle usage in the surrounding area. It becomes crucial to keep the muscles surrounding the fistula strong and functional, as these exercises help prevent disuse atrophy and ensure that the extremity remains versatile and coordinated.

Maintaining muscle strength is especially important in the context of patients who may already have compromised circulation or decreased activity levels due to their underlying condition. Regular movement through ROM exercises can provide ongoing stimulation to the muscles, aiding in their preservation and function, which is critical for overall limb health and the effectiveness of hemodialysis treatments.

In the case of managing pain or reducing swelling, those might be secondary benefits that could arise from improved circulation or maintaining activity, but the primary goal in this context is to focus on muscle strength to support daily activities and overall mobility. Without these exercises, there is a risk of weakness and decreased functionality in the limb, which could complicate care related to the AV fistula.