A carotid endarterectomy is a surgical procedure that removes atherosclerotic plaque from the carotid artery. Clients with carotid artery disease are at increased risk for transient ischemic attack and stroke. Post-surgical risks include cerebral ischemia and infarction as well as bleeding. Blood pressure is closely monitored during the first 24 hours post surgery. Hypertension may strain the surgical site and trigger hematoma formation, which can cause hemorrhage or airway obstruction. Systolic blood pressure is maintained at 100-150 mm Hg to ensure adequate cerebral perfusion and avoidance of hemorrhage or strain.

(Option 2) It can take 24-48 hours for peristalsis to return after bowel surgery due to manipulation of the bowels and anesthesia. This client should be monitored for return of bowel function and should be assessed last.

(Option 3) Clients with atrial fibrillation may experience tachycardia and irregular heart rhythm even with treatment. This client should be assessed after the client with an endarterectomy.

(Option 4) Total parenteral nutrition (TPN) should never be discontinued abruptly (due to the risk for hypoglycemia). This client should be seen third so that TPN is not interrupted