Page 1681 - Saunders Comprehensive Review For NCLEX-RN

discuss anxieties and fears related to
surgery.
h. Note that prescribed medications may
be discontinued preoperatively
(usually, diuretics 2 to 3 days before
surgery, digoxin 12 hours before
surgery, and aspirin and
anticoagulants 1 week before surgery).
i. Administer medications as prescribed,
which may include potassium
chloride, antihypertensives,
antidysrhythmics, and antibiotics.
3. Cardiac surgical unit postoperative interventions
a. Mechanical ventilation is maintained
for 6 to 24 hours as prescribed.
b. The heart rate and rhythm, pulmonary
artery and arterial pressures, urinary
output, and neurological status are
monitored closely.
c. Mediastinal and pleural chest tubes to
the water seal drainage system with
prescribed suction are present;
drainage exceeding 100 to 150 mL/hr is
reported to the PHCP.
d. Epicardial pacing wires are covered
with sterile caps or connected to a
temporary pacemaker generator; all
equipment in use must be properly
grounded to prevent microshock.
e. Fluid and electrolyte balance is
monitored closely; fluids are usually
restricted to 1500 to 2000 mL, because
the client usually has edema.
f. The blood pressure is monitored
closely, because hypotension can cause
collapse of a vein graft; hypertension
can cause increased pressure,
promoting leakage from the suture
line, causing bleeding.
g. Temperature is monitored and
rewarming procedures are initiated
using warm or thermal blankets if the
temperature drops below 96.8° F
(36.0° C); rewarm the client no faster
than 1.8 degrees/hr to prevent
shivering, and discontinue rewarming
procedures when the temperature
approaches 98.6° F (37.0° C).

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