Answer to Question 1
Answers: b, c, d
Elevation of HOB should not exceed 30 to 40 degrees because sharp hip flexion could cause
the graft to kink. Knees should not be bent because knee flexion compresses popliteal vessels,
restricting venous return. Dressing changes should be done with careful aseptic technique. Careful
and regular assessment for decreased tissue perfusion (see previous text) should be done to detect
leak, rupture, or occlusion of the graft.
Answer to Question 2
Pain from his surgery.
Confusion or disorientation related to the surgical intervention.
Risk for infection as a result of the surgery.
Possible altered systemic tissue perfusion as the result of a leak, rupture, or occlusion of the aortic
graft.
Possible hypoventilation (breathing too shallowly) because of pain and history of sleep apnea and
abdominal surgery.
Possible constipation because of his history of constipation, pain medication use, and the
abdominal surgery (inability to bear down effectively to create sufficient intra-abdominal
pressure).
VTE (venous thromboembolism) prophylaxis. Typically, a parenteral anticoagulant such as a
low-molecular-weight heparin is ordered subcutaneously, and/or mechanical prophylaxis such as
intermittent pneumatic compression devices (ICPDs) are implemented after surgery.
Reduced physical mobility as a result of his surgery.