A nurse is caring for a client post-endarterectomy for carotid artery stenosis. What is the priority nursing intervention during the immediate postoperative period?
A.
Monitoring for signs of stroke
B.
Assessing the surgical incision for bleeding
C.
Administering pain medications
D.
Encouraging coughing and deep breathing
The Correct Answer and Explanation is:
Correct Answer: B. Assessing the surgical incision for bleeding
Explanation:
Post-endarterectomy care, particularly following a carotid artery endarterectomy, requires vigilant monitoring and intervention to ensure optimal recovery and prevent complications. In the immediate postoperative period, the priority nursing intervention is assessing the surgical incision for bleeding. Here’s why this is crucial:
1. Risk of Hemorrhage: One of the most critical concerns immediately after a carotid endarterectomy is the risk of postoperative hemorrhage. The surgical site, particularly where the carotid artery has been manipulated or repaired, is susceptible to bleeding. Any uncontrolled bleeding can rapidly lead to significant blood loss, which can jeopardize the patient’s hemodynamic stability and overall recovery. Therefore, frequent and thorough assessment of the incision site for any signs of bleeding is essential to identify and address hemorrhage early.
2. Early Detection of Complications: Assessing the surgical incision helps in the early detection of potential complications such as hematoma formation, which can compress the airway or surrounding structures and lead to further issues. Immediate identification of bleeding or hematoma allows for prompt medical intervention, which can significantly reduce the risk of adverse outcomes.
3. Prioritization Over Other Interventions: While monitoring for signs of stroke (Option A), administering pain medications (Option C), and encouraging coughing and deep breathing (Option D) are all important components of post-operative care, they come after ensuring that the surgical site is not experiencing excessive bleeding. Stroke signs, pain management, and respiratory support are crucial, but they should be addressed after confirming the surgical site is stable.
4. Immediate Postoperative Monitoring: During the immediate postoperative period, the focus is on ensuring the patient’s stability and identifying any life-threatening issues. Bleeding at the surgical site takes precedence because it can directly impact the patient’s cardiovascular status and immediate safety.
In summary, assessing the surgical incision for bleeding is the priority nursing intervention post-endarterectomy to ensure that any potential hemorrhage is detected and managed promptly, which is essential for patient safety and recovery.