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Acute Occlusion
Traumatic transection or occlusion Diagnostic procedures such as angiography Disorders associated with embolus formation
Chronic Occlusion
Atherosclerosis Aneurysm of the popliteal artery Chronic Infection Restenosis of previous graft
Potential Complications
Hematoma formation Infection Emboli or thrombi Gangrene Skin ulcers
Nursing Priority
Maintain arterial blood flow
2.
Baseline assessment permits later comparison of data. A surgical drain may be in place to remove lymph or blood. Drainage should be minimal and bright red initially becoming serous within 24hrs. Disruption of graft anastamosis, hemorrhage of soft tissues, or drainage from severed lymph vessels can induce enough fluid to occlude the graft. Fluid collection causes the skin to become taut, with a dimpled appearance. A mass will be palpable. Surgical fluid removal is necessary if graft occlusion is imminent. Eccymosis indicates arterial bleeding and possible disruption of the anastamosis. Decreased H/H may indicate bleeding also.
5.
Activity Post Op
The patient should not hyperextend their affected extremity. The patient s activity can gradually be increased based on his or her tolerance. Patient should be out of bed as soon as he/she can tolerate sitting up in bed to minimize risk for atelectasis.
If any concerns or unaware of what to do for a patient with complications status post femoral-popliteal bypass graft use: femoralChain of Command (Lead, Manager, CPM) Notify Physician Initiate RRT