Page 1720 - Saunders Comprehensive Review For NCLEX-RN

flow around the occlusion. Inflow
procedures bypass the occlusion above
the superficial femoral arteries and
include aortoiliac, aortofemoral, and
axillofemoral bypasses; outflow
procedures bypass the occlusion at or
below the superficial femoral arteries
and include femoropopliteal and
femorotibial bypass (Fig. 52-12).
5. Preoperative interventions
a. Assess baseline vital signs and
peripheral pulses.
b. Insert an IV line and urinary catheter as
prescribed.
c. Maintain a central venous catheter
and/or arterial line if inserted.
6. Postoperative interventions
a. Assess vital signs and notify the PHCP
if changes occur.
b. Monitor for hypotension, which may
indicate hypovolemia
c. Monitor for hypertension, which may
place stress on the graft and cause clot
formation.
d. Maintain bed rest for 24 hours as
prescribed.
e. Instruct the client to keep the affected
extremity straight, limit movement,
and avoid bending the knee and hip.
f. Monitor for warmth, redness, and
edema, which often are expected
outcomes because of increased blood
flow.
g. Monitor for vessel or graft occlusion,
which often occurs within the first 24
hours.
h. Assess peripheral pulses and for
adverse changes in color and
temperature of the extremity.
i. Assess the incision for drainage,
warmth, or swelling.
j. Monitor for excessive bleeding (a small
amount of bloody drainage is
expected).
k. Monitor the area over the graft for
hardness, tenderness, and warmth,
which may indicate infection; if this
occurs, notify the PHCP immediately.

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