A nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing an aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. The nurse interprets that the neurovascular status is:
A. Normal because of the increased blood flow through the leg.
B. Slightly deteriorating and should be monitored for another hour.
C. Moderately impaired, and the surgeon should be called.
D. Adequate from the arterial approach, but venous complications are arising.
Correct Answer: A. Normal because of the increased blood flow through the leg.
An expected outcome of surgery is warmth, redness, and edema in the surgical extremity because of increased blood flow. Aortofemoral bypass surgery is a procedure utilized commonly for the treatment of aortoiliac occlusive disease, sometimes referred to as Leriche syndrome. Aortoiliac occlusive disease can contribute to lower extremity ischemic symptoms necessitating intervention.
Option B: A common complication following surgery is renal insufficiency. This condition is typically a result of prolonged ischemia after clamping suprarenal, embolization secondary to clamping, hypoperfusion, hypovolemia or intrinsic renal artery disease.
Option C: Often, this post-operative complication directly relates to the patient’s preoperative cardiac and renal function. Knowing your patient’s anatomy and having a precise plan preoperatively for clamping help reduce the incidence of renal insufficiency in the perioperative period.
Option D: Eighty percent of aortobifemoral bypass surgeries are successful and open the artery and relieve symptoms for approximately 10 years after the procedure. Pain is usually relieved when the patient is resting and greatly reduced when walking.
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