Bypass Surgery: Preoperative Nursing Care (05:28)
A CABG pre-op assessment should include medical history, allergies and risk factors, current medications, and dose times. Lab work includes a CBC, urinalysis, bleeding time, prothrombin time, and chemistry panel. View medications affecting coagulation cascade and learn about patient and family instructions.
Day of Surgery (02:15)
Use the saphenous vein and radial arteries to bypass coronary artery lesions. Divert blood to the bypass machine, cool core temperature, and stop the heart until the bypass is complete. Place chest tubes and pacemaker wires and close the sternum.
Transfer CABG patients to the ICU or PACU. Learn about cardiopulmonary support, wound management, pain control interventions, and systems requiring monitoring. Change positions frequently, begin incentive spirometer exercises, help the patient to sit, and offer liquids. Educate the family on home care.
Post-op Day One (02:59)
View nursing goals for CABG patients. They should move around as soon as possible, and use the incentive spirometer hourly. If recovery is proceeding according to schedule, patients can transfer to telemetry and start cardiac rehabilitation.
Post-op Day Two through Five (04:36)
Nursing goals for CABG patients include: assessment, education, pain control, GI normalization, wound management, cardiac rehabilitation, and lifestyle modification. Complete assessments are required during each shift; activities and diet should progress. Encourage incentive spirometer exercises and review discharge instructions.
Credits: Bypass Surgery: DOS and Postoperative Care (00:17)
Credits: Bypass Surgery: DOS and Postoperative Care
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