An endarterectomy is surgical removal of atherosclerotic plaque from a person's arteries.
An endarterectomy is the removal of atheromas from arteries. Patch graft repair of the vessel is performed.
Possible complications of an endarterectomy include bleeding or hematoma occurring at the surgical site, stroke, thrombosis, neurologic deficits, infection, and cranial nerve injury.
Great nursing care and assessment is key to preventing or spotting these conditions.
Preoperative Nursing Interventions
- Complete the patient and family preoperative teaching
- Explain the procedure to the patient
- Describe the operating room, PACU, preoperative and postoperative routines
- Demonstrate postoperative turning, coughing, deep breathing, and ROM exercises
- Explain the postoperative need for monitoring devices, drainage tubes, surgical dressings, oxygen therapy, IV therapy, and pain control
- Complete a preoperative checklist and obtain signed informed consent
- Administer preoperative medications as prescribed
- Allay the patient's and his family's anxiety about surgery
- Protect the surgical site form trauma
- Perform a preoperative vascular assessment
Postoperative nursing interventions
- Check the surgical site for bleeding
- Provide special care for a carotid endarterectomy
- Check for neck edema and airway patency
- Assess ability to swallow
- Assess cardiac, respiratory, and neurological status
- Assess pain level, administer postoperative analgesics as prescribed, and evaluate response
- Assess for return of peristalsis; give solid foods and liquids, as tolerated
- Allay the patient's anxiety
- Provide wound care
- Encourage turning, coughing, deep breathing, and use of incentive spirometry
- Place the patient in the semi-Fowler's position
- Maintain the patient's head in a neutral position
- Maintain activity: active or passive ROM and isometric exercises, as tolerated
- Monitor vital signs, I/O, laboratory studies, neurovital signs, neurovascular checks, and pulse oximetry
- Monitor and maintain the position and patency of drainage tubes,: NG, indwelling urinary catheter, and wound drainage
- Administer anticoagulants if prescribed
- Individualize home care instructions
- Teach patient about the disorder and its implications
- Follow instructions for medication use and be aware of possible adverse effects
- Protect the surgical site from trauma
- Recognize the signs and symptoms of infection
- Monitor for motor and sensory deficit
Straight As in medical-surgical nursing. (2008). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.