Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing
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Thoracoabdominal aortic aneurysm repairs present many challenges, and the complication of paraplegia remains a concern for both the surgeon and the nurse caring for the patient in the postoperative period. Paraplegia can occur secondary to spinal cord ischemia from prolonged aortic clamping during the repair of the descending thoracic aorta. Paraplegia is a devastating complication for the patient and family. ⋯ One such method is the use of external CSF drainage during the operation, followed by use of a lumbar drain system for as long as 72 hours after the operation. This system setup uses a transducer to monitor CSF pressure and a drip chamber to drain CSF to maintain a normal pressure. This article describes thoracoabdominal aneurysms, surgical techniques to repair the aneurysm, and the use of external CSF drainage and related nursing care measures.
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Although uncommon during pregnancy and the postpartum period, deep vein thrombosis (DVT) and its sequela, pulmonary thromboembolism, remain leading sources of maternal mortality and morbidity. The majority of literature concerning DVT in pregnancy and the postpartum period exists in the medical journals, with only a small amount in nursing journals. This article provides the nursing community a comprehensive review of literature concerning the incidence of both DVT and pulmonary embolism in pregnancy and the postpartum period, identification of risk factors, the effectiveness of available screening and diagnostic tools, and finally, options for treatment and prophylaxis.
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Epidural analgesia affords new opportunities for pain management in the acute and chronic arenas for patients undergoing vascular surgery. Effective and safe management of the patient receiving epidural analgesia requires careful integration of the skills and knowledge of the health care providers. ⋯ Thus development of standardized nursing care plans to ensure safe and appropriate care of patients is imperative. Monitoring specific quality indicators ensures safe delivery of epidural analgesia and evaluates the effectiveness of the pain management program.
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Extracavitary vascular injuries involving the cervical area and the extremities constitute about 50% of all vascular injuries. Initial evaluation and resuscitation of patients with vascular injuries should follow standard Advanced Trauma Life Support protocols. ⋯ Postoperative nursing care focuses on the entire patient including the detection of early complications of vascular repair. Recent advances in transportation, resuscitation and operative techniques have lead to a decrease in mortality and morbidity.