What is a Carotid Endarterectomy? and nursing care Flashcards
removal plaque from carotid artery through incision in neck - 2 carotid arteries and vertebral arteries = circle willis = provide circ to brain - surgery helps reduce risk stroke
Carotid endarectomy -
Tests: determine extent carotid disease - carotid US
Carotid angiography - tube in groin to get good pic
MRA
CTA - CT scan with injection of dye
Prepare for surgery
Allergic or sensitive to meds: iodine, tape, latex
List meds including prescribed, OTC, herbal, supplements
Hx bleeding disorders or taking anticoag
Tell doc
Not eat/drink after midnight
Ask doc if can take prescribed meds
Stay in hospital 2-3 days
Day before surgery
Admitted to pre-op
Sign consent for surgery
Nurse insert peripheral line
Draw set labs
Leave belongings with fam members
Foley catheter inserted to drain bladder
Anesthesiologist - may give sedative in IV; arterial line in wrist - monitor BP continuously
Go into op room - surgeon perform making skin incision over carotid artery - clamps above and below blockage temporarily blocking blood flow from carotid - 3 other arteries flowing to brain; other issues with carotid may place a shunt until able loosen plaque around arterial wall; close with patch/sutures, remove clamps, suture skin with small tube to drain excess blood
1-2 hr surgery
Day surgery
Recovery area
Wake up 1-2 hrs
CVICU/ICU - monitor HR and BP frequently via arterial line in wrist; systolic BP 100-150 - come out hypertensive due to manipulation of carotid and receptors present; give continuous IV med to keep BP low
Post-op
Drain from surgery removed if not too much blood
Arterial line removed if BP controlled
Diet adv
Allowed out of bed
Sometimes discharged this day if now complications
Day after surgery
Low risk
Transient ischemic attack/stroke
Swallowing problems
Heart attack
Bleeding
Infections in wound
Complications
Low risk
Transient ischemic attack/stroke
Swallowing problems
Heart attack
Bleeding
Infections in wound
Complications
