hard · NCLEX-RN risk-reduction
The nurse is caring for a client who is 12 hours postoperative from a femoral-popliteal bypass graft. The client's pedal pulse on the operative side was previously 2+ and is now only palpable with a Doppler. The foot is cool to the touch.
What is the priority nursing intervention?
- Notify the surgeon immediately of the change in neurovascular status.
- Document the finding and re-evaluate the pulse in one hour.
- Wrap the foot in a warm blanket to improve peripheral circulation.
- Encourage the client to perform ankle pumps to stimulate blood flow.
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