About
Coronary artery bypass graft- surgery to bypass occluded or damaged coronary arteries to re-establish blood flow to myocardial tissue.
Assess
Monitor ventilation equipment initially, arrhythmias, edema, electrolyte imbalances, urine output, vital signs, pain management, level of consciousness
Complications
Cardiac tamponade, bleeding, infection, electrolyte imbalances, hypothermia
Diagnosis
- Knowledge deficit related to perioperative procedures
- Acute pain related to tissue damage
- Risk for injury related to impaired skin integrity
Goals
- The client will remain free from complications related to procedure.
- The client will state understanding of pre-, intra-, and post-operative activities.
Interventions
- Initiate telemetry, oxygen, nitrates, morphine, antiplatelets, anticoagulants, etc. as ordered.
- Monitor fluid and electrolytes, and administer medications to maintain balance as ordered.
- Monitor vital signs, telemetry, intake and output, and chest tube sites and drainage.
- Post-operatively, monitor VS every 15 minutes X 2, every 30 Minutes X 2, every 1 hour X 2, than every 4 hours ( may have different guidelines for each clinical agency).
- Monitor site for signs of bleeding and monitor for angina, hypothermia, hypertension, arrhythmias, and hypotension.
- Use sterile technique when changing surgical dressings.
- Administer warming blankets as ordered.
- Teach client what to expect pre-, intra-, and post-operatively.
- Administer medications ( analgesics, antidysrhythmics, etc.) as ordered.
- Teach client side effects and adverse reactions of medication therapy.
- Teach client lifestyle changes and discharge care.
- Monitor for signs/ symptoms of complications.
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