Vascular Repair
Vascular repair surgery often represents the treatment of choice for vessels damaged by arteriosclerotic or thromboembolic disorders (such as aortic aneurysm or arterial occlusive disease), trauma, infections, or congenital defects. It may also be used for patients with obstructions that severely compromise circulation or for patients with vascular disease that doesn’t respond to drug therapy or nonsurgical treatments such as balloon angioplasty. Emergency surgery is typically required for life-threatening dissecting or ruptured aortic aneurysms or limb-threatening acute arterial occlusion.
Vascular repair includes aneurysm resection, bypass grafting, embolectomy, and vein stripping. The specific surgery used depends on the type, location, and extent of vascular occlusion or damage.
Procedure
Vascular repair surgeries are usually performed under general anesthesia. (See Understanding types of vascular repair, page 952.)
Complications
All vascular surgeries carry the potential for serious complications, such as vessel trauma, emboli, hemorrhage, and infection. Bypass grafting carries added risks: The graft may occlude, narrow, dilate, or rupture.
Key nursing diagnoses and patient outcomes
Anxiety related to vascular repair and potential for complications. Based on this nursing diagnosis, you’ll establish these patient outcomes. The patient will:
identify and express feelings of anxiety
use available support systems to cope with anxiet
exhibit healthy coping behaviors for dealing with anxiety.
Risk for injury related to complications associated with vascular repair. Based on this nursing diagnosis, you’ll establish these patient outcomes. The patient will:
not have signs or symptoms of organ dysfunction after surgery
regain and maintain adequate tissue perfusion, demonstrated by strong, palpable pulses and warm skin with no evidence of cyanosis
not complain of discomfort suggestive of tissue ischemia, such as chest pain or sensory changes in his extremities.
Activity intolerance related to location of surgical incision. Based on this nursing diagnosis, you’ll establish these patient outcomes. The patient will:
communicate an understanding of the need to maximize his activity level and show a willingness to do so
not show signs and symptoms of inactivity-related complications, such as thrombus formation and skin breakdown
regain and maintain his normal activity level.
Nursing interventions
When caring for a patient undergoing vascular repair surgery, your main responsibilities include instructing the patient and monitoring for preoperative and postoperative complications.
