Coronary Artery Graft Bypass - CABG Flashcards
What is a coronary artery bypass graft - CABG?
a coronary artery bypass graft is a procedure where a graft is taken from another muscle/vesicle:
generally taken from:
**internal mammary artery
**saphenous vein (leg)
What is the difference between a normal CABG and an off-pump CABG?
with a normal CABG, a machine is used to circulate + oxygenate the patients blood which is NECESSARY and GOOD; however, this adds risks involved with this procedure!
with an off-pump CABG, the patient pumps and circulates their own blood without the help of the pump
Why would you use an off-pump CABG procedure?
off-pump CABG is used for HIGH RISK PATIENTS only because they cannot generally handle their blood being pulled out
What is important to know as a nurse for post-op CABG patients?
-most patients will require a 24-36 hour ICU stay; followed by a ICU stepdown unit stay
-your patient will have:
**a pulmonary artery cath
**plural + medial chest tubes
^^^these MUST be draining
-patient needs continuous EKG monitoring
-patient needs continuous pulse OX monitoring
- patient will probably be intubated **BUT goal is to be extubated quickly + physical therapy initiated quickly
- patient will probably have epicardial pacing wires connected to an external pacemaker!
What does post-op care look like for a patient that had a CABG/off-pump CABG?
#1: assessment #2: lab work #3: early interventions as needed/necessary
Post-Op Care: #1 Assessment
- assess for HYPOthermia; post-op patients have increased risk for developing hypothermia
- continuous EKG monitoring ***A-FIB is very common after this procedure = high risk
- ensure the tubes are DRAINING
- check/monitor insertion sites (any bleeding? any separating? any S/S of infection?
Post-Op Care: #3: Early Interventions
- **cough w/ splint pillow
- incentive spirometer
- *pain medication + pain control/comfort
- *tubes taken out ASAP - prevent infections
- educate family on the importance of good support and help at home
