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I'm by no means a cardia nurse!



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Dec 16, 2008 02:50 PM

I'm by no means a cardia nurse!


Hi to all and thank you in advance for taking the time to read this. I am an RN with experience in L&D, PostPartum, Mother/baby. The closest i've ever been to a cardiac pt was the maniquin in ACLS class! I had to be ACLS certified in my old L&D unit because we recovered our own pts in PACU after c-sections. Now to my question.... my fiance has a history of stint placement due to CAD. He's had three stints placed in the past 7 years. He has been experiencing SOB, chest pressure, and fatigue so he had another cath this past week. The cardiologist said that he has 100% blockage of his right coronary artery, and I think 80% blockage of his circumflex. The doctor said his disease is more advanced than what he saw with his last stint two years ago and feels that it is time for CABG. He will require a triple bypass. He is already on statins, asa, and BP meds. The increased BP is something very new. No hx of that. He's always been very physically active, not overweight, doesnt smoke. So what should we expect with bypass surgery in terms of procedure, recovery, life after bypass?


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5 Comments
No. 1
from jmgrn65
Old Dec 16, 2008, 03:52 PM

Default Re: I'm by no means a cardia nurse!
Recovery in hospital is avg. 4-5 days, alot depends on the patient they have to get up out of bed and walk. No lifting pulling and straining for aprox 3 months. After recovery life should be back to normal except for lifestyle changes diet and exercise.
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No. 2
from Virgo_RN
Old Dec 18, 2008, 03:49 AM

Default Re: I'm by no means a cardia nurse!
Sorry, don't mean to be picky, but it's "stent".

CABG does not cure CAD, it is palliative. He will still need to be on his meds and practice heart healthy eating habits following his surgery. Hopefully the hospital has a good program for cardiac rehabilitation so that he can tailor his exercise regime under medical supervision.

A lot of hospitals have educational classes for families and patients, so they know what to expect prior and following the actual surgery. Can you check into that?
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No. 3
from NurseLay
Old Dec 22, 2008, 02:50 PM

Default Re: I'm by no means a cardia nurse!
Virgo RN, thanks for being picky because "stint" was annoying the hockey sticks out of me!
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No. 4
from al7139
Old Dec 24, 2008, 02:10 AM

Default Re: I'm by no means a cardia nurse!
Hi,
Your husband sounds like my dad, who had a x4 bypass a few years ago (keep in mind he was in his 70's!). He was an unfortunate slave to genes and not an unhealthy lifestyle. My dad is active (to the point of obsession), and so incredibly healthy that we were amazed when we found that he had to have this surgery.
At the time, I was doing my prereqs for nursing school, so you can imagine that I was really interested in all that was happening (second to being scared that my dad might not get through it!).
I can tell you this of our experience:
First we were thoroughly educated on what to expect in the hospital even before he went to have the surgery, this included preop, postop, and also my dad was taught lots of alternative pain management options and coping skills for immediately post op, like meditation skills, breathing techniques, and guided imagery (keep in mind that they open the chest at the sternum for this), and it really worked for him, he barely used pain meds, which I think is incredible.
Even before sx, they were planning home care, outpatient therapy (which includes a support group), how we care for him, etc.
On the day of the surgery, he went to preop, while the families got a tour of the CICU, and a nurse explained what our loved one would have going on (tubes, catheters, meds, etc.) and how long they would stay (12-24 hours) before transfer to a stepdown unit.
I gotta say, the wait during the surgery was horrible, especially knowing they stop the heart to operate.
The surgeon came out immediately after to let us know he was OK, and then we waited until he was awake and stable before we could see him.
When I saw my dad, he was still inubated, but A&O, and able to tell us he was feeling fine, and in no pain. They generally keep a pt intubated for 12-18 hour after sx even if they are awake, to prevent resp distress and ensure oxygenation (since a pt who has had their chest opened generally does not want to breathe too deeply since it hurts.
He did fine and was transferred to stepdown the next day, and was discharged 4 days later. The nurses got on him for trying to do too much, but my dad was never able to sit around so bedrest drove him crazy.
Now, several years later (and in his early 80's) he is as active as ever, and unstoppable.
I know some people don't do as well, but he did really great even at his age.
Not saying don't worry, but this was my experience, and I hope it helps you know what to expect.
Amy
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No. 5
Old Jan 15, 2009, 02:51 PM

Default Re: I'm by no means a cardia nurse!
Thanks to all that posted a reply. I appreciate you taking the time to do so. I can't believe I spelled stent wrong! I did know the correct spelling...just don't use it much. I'm so embarrassed! Anyhow surgery went well and he is home recovering. He ended up having a quadruple bypass! Everything went as expected. Actuallly even better than expected! Thanks again for the replies. Take care!
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