Fundamentals of Nursing Q 510
A client is to be on bed rest for 24 hours and the affected extremity is to be kept straight during this time. Which of the following procedures would require a client to do the above?
A. Varicose vein surgery.
B. Myelogram.
C. Abdominal aneurysm resection.
D. Arterial Vascular Grafting.
Correct Answer: D. Arterial Vascular Grafting.
To promote graft patency after the procedure, bedrest is maintained for the first 24 hours and the affected extremity is kept straight. The pathophysiology of vein graft failure has been attributed to acute thrombosis within the first month, intimal hyperplasia up to 1 year, and atherosclerosis beyond 1 year.
Option A: After treatment of large varicose veins by any method, a 30- to 40-mm Hg gradient compression stocking is applied, and patients are instructed to maintain or increase their normal activity levels. Most practitioners also recommend the use of gradient compression stockings even after treatment of spider veins and smaller tributary veins.
Option B: The client may need to sit or lay down for several hours after the procedure to reduce the risk of developing a CSF (cerebral spinal fluid) leak. Most patients are asked to lie down for two hours after the procedure. If the client needs to urinate, he may need to do so in a bedpan or urinal during the time that he needs to stay flat.
Option C: Avoid strenuous activities that may put stress on the incision, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 6 weeks or until the doctor says it is okay. For 6 weeks, avoid lifting anything that would make a strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.