This is vital!
A patient develops an irregularly irregular heart rhythm 2 days after CABG. What arrhythmia is most likely?
Atrial fibrillation
In the "4 W's" of post-operative fever, what does wound represent and what do you check for?
Superficial or Deep infection
What to check for → redness, warmth, increased pain, drainage
This is the normal second heart sound, caused by closure of the aortic and pulmonic valves.
S2
CABG stands for this.
coronary artery bypass graft
Nick is afraid to cough or take deep breaths because he thinks his incision will open. What intervention helped him overcome this fear?
patient education about safe movement
coughing/deep breathing
sternal precautions
A patient's blood pressure drops to 85/50 mmHg and feels dizzy when standing. This vital sign finding may indicate this problem.
orthostatic hypotension
In the "4 W's" of post-operative fever, what does wind represent and why is it a risk?
Pneumonia, aspiration, PE
Anesthesia and immobility→ altered ventilation→ higher secretion retention
Pain and opioids → can shallow breathing
This is the normal first heart sound, caused primarily by closure of the AV valves.
S1
What is the primary goal of CABG surgery?
Restore blood flow to heart muscle by bypassing blocked coronary arteries.
This is the level of medical care focused on prevention
Primary
Why might a patient experience hypotension after CABG?
Reduced circulating volume
decreased cardiac output
In the "4 W's" of post-operative fever, what does walking represent and why is it a risk?
DVT (usually LE)/PE
Less mobility, more venous stasis
This heart sound occurs immediately after S2 and is associated with rapid ventricular filling.
S3
After CABG, continuous EKG monitoring is important because patients are at increased risk for these
arrhythmias
This is the level of medical care focused on diagnosis and evaluation
A post-op patient's SpO₂ drops from 96% to 87% during ambulation. What could this indicate?
hypoxemia
In the "4 W's" of post-operative fever, what does water represent and why is it a risk?
UTI/CAUTI
Foley catheter → bacteria can enter urinary tract
longer the catheterization, higher the risk
What does an S4 heart sound indicate?
This type of blood vessel is commonly harvested from the leg and used as a bypass graft
saphenous vein
This is the level of medical care focused on specialized care
tertiary
A post-CABG patient's EKG suddenly shows a chaotic, irregular waveform with no identifiable P waves or QRS complexes. What rhythm is this?
V fib
If "wonder drugs" was this mystical "5th W" what would you need to think about?
Could one of the medications be causing a fever
What could lung crackles indicate?
fluid/mucous build up in lungs
This ICU is commonly responsible for the immediate post-operative care of a patient following major cardiac surgery.
CTICU (Cardiothoracic Intensive Care Unit)
Why would a patient be transferred from the CTICU to a step-down unit
They are medically more stable and no longer require the highest level of continuous intensive-care monitoring