Question

CASE STUDY 1: Cardiovascular

Answer each question in detail. Please be very clear as to which case study and which question you are answering. You should number your answers according to the case study questions.

Mr. J.L is a 62-year-old male who is scheduled to have coronary artery bypass surgery. His father died of myocardial infarction (MI) at 65 years of age. Mr. J.L. has recently quit smoking. His cholesterol is 220 mg/dL with an HDL of 40 mg/dL. You are the nurse caring for Mr. J. L.

Critical Thinking Questions:

• 1. What will you do to prepare Mr. J.L. for surgery?

• 2. What assessments will you perform for Mr. J.L. when he is awaiting surgery?

• 3. What will be two priority nursing diagnoses in the postoperative period?

• 4. What are the three key nursing interventions? Provide a rationale for each.

• 5. When he is transferred out of critical care, what complications will you monitor for Mr. J. L.?

Answer 1

1.Some of the things which has to be done to prepare Mr.J.L for surgery are

• Blood investigations, chest X ray, ECG,2D Echo, Urine analysis,cross match and reserve g blood for surgery
• To keep patient NBM from midnight
• Skin preparation like shaving off the chest and abdomen, back , perianal area ,low limbs.
• To get consent ready from the patient after thorough explanation
• Educating about the surgery and the post op care
• Clarify all the doubts of the patient

2.The assessment which has to be done are

• Vital signs recording
• Intake and output measurement
• Check for any food or medication allergy
• Any medication history

3.The priority nursing diagnosis after surgery are

• Acute pain in chest related to surgical incision as evidence by dressing, pain score
• Risk for infection related to surgery as evidenced by verbalisation

4.Nursing intervention and rationale

• Monitor vital signs,is the baseline to plan for care
• Administer analgesics to reduce pain and antibiotics to prevent infection
• Administer oxygen to maintain airway patency

5.The complications to be monitored are

• Bleeding
• Infection
• Renal failure
• Lung failure
• Stroke