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Med Surg Quiz 3 Coronary Artery Bypass Graft Post Op
Coronary Artery Bypass Graft (CABG) Post Op Nursing Care
Terms in this set (11)
What are three high priority assessments in post CABG patients?
Fluid and electrolyte imbalances (esp. potassium and magnesium, which can cause dysrhythmias)
What do you think is the most common complication after CABG?
Atelectasis (an abnormal condition characterized by the collapse of alveoli, preventing the respiratory exchange of carbon dioxide and oxygen in a part of the lungs).
How can you avoid atelectasis after CABG?
Dangle legs soon after extubation (usually within 8 hours)
Turn, Cough, Deep Breath (TCDB); splint sternal incision site with pillow
Use of Incentive Spirometer
How would hypotension cause problems in post CABG pts?
May result in collapse of graft vessel
Pt. with hypotension may need fluid replacement (e.g. blood transfusion)
How would hypertension cause problems in post CABG pts.?
Increase pressure on suture sites-->increased bleeding
Post CABG pt will likely have several plural chest tubes to drain blood. How much bleeding is considered abnormal?
More than 150ml/hour - or if sudden drastic change: notify MD stat
Pt. has 120ml drainage in past hour and drainage suddenly stops. What should you do?
#1 check patient
Check tubing for kinks, dependent loops
Ensure drainage container is below the level of the heart
If myocardium is compressed with blood that can't drain --> cardiac tamponade (medical emergency). What are classic symptoms of cardiac tamponade?
Sudden decrease or cessation of chest tube drainage
Jugular vein distention
Hypotension (with equalizing systolic and diastolic BP)
Pain management; angina-like pain may indicate graft failure. How does incisional pain differ from angina pain?
Incision: often described as sharp, does not radiate, increases with deep breathing, coughing, movement.
How many days post-CABG surgery may s/s of infection at sternal incision site become evident?
Approximately 4-7 days
What are s/s indicating patient has sternectomy infection?
Instabilility (bogginess) of sternum - mushy - swelling
Redness, induration, purulent drainage from suture site
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