1. Joan Arnold, 67 years of age, is a female patient who underwent a coronary angiogram...

1. Joan Arnold, 67 years of age, is a female patient who underwent a coronary angiogram that diagnosed severe coronary artery disease in three of her coronary arteries, the left anterior descending, the left circumflex, and the right coronary artery. She is scheduled for a coronary artery bypass graft operation tomorrow. The nurse provides patient education for Mrs. Arnold and her husband, which includes watching a hospital video on the operation, the intensive care environment, what to expect after the surgery, the recovery period, and cardiac rehabilitation. The video also covered the importance of coughing and deep breathing, using an incentive spirometer, splinting, early ambulation, pain medication, and how to position oneself safely. The video stressed the importance of not rolling onto the side that the chest tube may be in place postoperatively. The video also discussed the preoperative preparation. The nurse also provided a booklet on the subject material. The nurse had a session with the patient and her husband to assess their understanding and to answer any questions they may have had. (Learning Objectives 6 to 8)

What specific preoperative nursing measures should the nurse review with the patient to help decrease the risk for postoperative complications?

Explain the role of the nurse when implementing the immediate preoperative preparation the day before surgery and the morning of the surgery?

Solutions

Expert Solution

What specific preoperative nursing measures should the nurse review with the patient to help decrease the risk for postoperative complications?

To relieve anxiety of patient, nurse should clear all her queries regarding surgery and peost surgery interventions

Providing reassurance on pain management by medications post surgery

Clear communication and reassurance to the patient and significant family members regarding surgery

Information on temporary ET tube placement and inability to speak due to that and its need for her

Reassurance that competent caregiver will support her for her needs

Reassurance on ET tube removal within a shorter span as it fulfils it purpose

Necessity of effective coughing inspite of incisional pain

Information on Length of the surgery

Importance of early mobilization

Explain the role of the nurse when implementing the immediate preoperative preparation the day before surgery and the morning of the surgery?

Complete Blood count checked and corrected information

Clotting screen

Creatinine and electrolytes corrected and checked information

LFT

Chest X-ray

Echocardiogram to assess LV function

Coronary angiography to identify the extent and severity o0f disease

MRSA screening

Premedications as ordered

Administartion of tamazepam and IV midazolam, Aspirin

Cross matching and keeping 6 units of fresh frozen plasma, paltelets, blood

Informed consent

Nightingale answered 1 year ago

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