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Nursing care plan ncp femoropopliteal bypass

Written by ncp nursing care plan on April 30th, 2011

Femoropopliteal Bypass

Lower extremity arterial bypass is performed to treat peripheral artery insufficiency that has not responded well to conservative management. The impaired blood flow can occur as a result of acute conditions (e.g., trauma, embolization) but most often is caused by atherosclerotic changes in the vessels. The femoropopliteal arterial segment is the most common site of occlusion in persons with lower extremity arterial disease. Surgical intervention is usually indicated when the client experiences signs and symptoms of severe occlusion (e.g., intermittent claudication that has become disabling, foot pain that is present at rest, presence of lower extremity ischemic ulcers) and/or when more conservative invasive treatment measures such as balloon angioplasty, laser angioplasty, stent placement, or percutaneous atherectomy have been unsuccessful.

Surgical treatment of the diseased femoropopliteal arterial segment can be accomplished by endarterectomy or removal of the segment and replacement with a synthetic graft, but the most commonly performed procedure is to bypass the segment using a synthetic or an autogenous vein graft. The saphenous vein is the preferred autogenous graft for femoropopliteal bypass because it is thick walled and has an adequate lumen diameter. Prior to grafting the saphenous vein proximal and distal to the occluded arterial segment, reversal of the vein or division of its valve cusps is done to allow unimpeded arterial blood flow.

Preoperative
Ineffective tissue perfusion: peripheral
Acute/Chronic pain: intermittent claudication and rest pain

Postoperative
Ineffective tissue perfusion: peripheral
Potential complications
graft occlusion
compartment syndrome
saphenous nerve damage
Deficient knowledge, Ineffective therapeutic regimen management, or Ineffective health maintenance

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Source Credits: Nursing Care Planning Guides: For Adults in Acute, Extended and Home Care Settings by S. P. Ulrich and S. W. Canale BSN MSN / Nursing Care Plans by M. Doenges MF Moorehouse Alice Murr