post op cardiac surgery care plan

Specialties Cardiac

Published

Im a senior I working on a hypothetical care plan for an 8 y/o male who underwent a Ross procedure for aortic valve stenosis this morning (??...the idea is that he has just returned to the floor from the PACU and he is my patient)

Anyways, Im going through my text and care plan book and it says that a common post op physical finding is an increase of 2-18 lbs. above the preoperative weight... Im thinking this is "water weight" from peri/post op fluids, but 18 lbs seems like an awful lot...

Any insight?

nursprl

104 Posts

Specializes in PICU, Pediatric Cardiac.

Hi there

A lot of it has to do with the patient's renal function and how well he is diuresing and how much fluid is given. I've taken care of pediatric cardiac patients and usually a day post-op a couple pounds is common. Thats why the hospital I use to work weighed their peds patients daily just so they can monitor how well they are diuresing. There we also cut the amount of fluid they were given post-op as well, cut maintenance fluids at 1/2 rate just to keep the edema from getting too out of control. Some edema post-op is common, but if you see increase in edema w/ low urine output, then that is where your rapid weight gain occurs. The higher weight gain may occur several days post-op, but I've only seen it when the diuresing is not going well. The doctors usually wait until post-op day one to start a patient on a diuretic. In my experience the docs like to give more fluid first to help diuresis before giving a diuretic immediate post-op because the fluid helps heart function and you don't want to go chasing your tail by diuresing a pt quickily where BP falls and you have to give fluid anyway. Hope this information helps you. If it's too rambly...sorry. If you need more information, drop me a line.

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