Paper Topic:

nursing management of patient post coronary artery bypass graph

CABG

Post-CABG Nursing

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[Institutional Affiliation] Post-CABG nursing care

Introduction

Coronary heart disease is a major physical illness and one of the main causes of death in Western society People who do not die an early and sudden death may have to consider a major surgical treatment , the most prevalent being coronary artery bypass graft surgery (CABG . More than 350 ,000 such operations are performed annually in the United States alone . This operation prolongs the life of patients in cases of triple-vessel disease It also improves patients

' quality of life , thus providing them with the opportunity for successful rehabilitation (Ben-Zur , 2000

The postoperative complications of CABG include the following : high anxiety or depression , central nervous system damage (CNS , and atrial fibrillation . In this , we will discuss the postoperative complications of CABG and how they impact nursing practice . During the first several weeks after CABG surgery , states of high anxiety or depression are usually observed (see , for example , Pick , Molloy , Hinds Pearce Salmon , 1994 Trzcieniecka-Green Steptoe , 1994 . In long-term research (that is , approximately one year after the operation , the results present a more positive trend in terms of elevation in positive moods (King , Porter , Norsen Reis , 1992 King Reis , Porter Norsen , 1993 , as well as an increase in quality of life (Kulik Mahler , 1993 . Such outcomes can be accounted for by illness severity factors . In addition , in recent years , the individual 's personality and coping characteristics have been investigated as important determinants of post-CABG patients ' emotional reactions and rehabilitation (Ben-Zur et al , 2000 . Research studies indicate that depression is prevalent in approximately 20 of CAD patients , and has a significant effect on post-surgery morbidity and mortality (Remedio 2003

One major type of morbidity following CABG is central nervous system (CNS ) dysfunction . Barbut D , Hinton et al . 1985 )] . Of all the adverse neurological outcomes that may be incurred postoperatively , stroke is one of the most serious . However , due to technological and surgical improvements the incidence of stroke is now reported to be as low as between 0 .8 and 5 .8 [McCann GM , et al . 1997 ) Duke University Medical Center study published in 2001 indicated that fully half of people undergoing bypass surgery developed memory or thinking problems in the days following it , and that these problems were usually still evident five years later (Bypass surgery and memory , 2005

Consequently , the rate of post-CABG stroke is no longer a sufficient index of CNS dysfunction . Neuropsychological research suggests , however that a considerable proportion of all patients who undergo CABG sustain some degree of cerebral damage and that this manifests as mild cognitive impairment . Although these cognitive deficits rarely disturb activities of daily living , they are still considered cause for concern . Therefore it is these less severe forms of neurological injury , which are now targeted for reduction in what has been described as an age of quality improvement (Stump D . A . 1995 Stump D . A , Rogers A .T , and Hammon J .W . 1996 ] .Cognitive impairment following coronary artery bypass grafting...

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