Overview
Coronary artery bypass grafting (CABG) is open heart surgery that restores myocardial perfusion by bypassing atherosclerotic coronary stenoses using autologous conduits — typica...
Coronary artery bypass grafting (CABG) is open-heart surgery that restores myocardial perfusion by bypassing atherosclerotic coronary stenoses using autologous conduits — typically the left internal mammary artery (LIMA) to the left anterior descending (LAD) and saphenous vein grafts (SVG) to other vessels. It is indicated for left main coronary disease, triple-vessel disease with reduced ejection fraction, or failed PCI/ongoing ischemia. Missing early post-operative complications — particularly cardiac tamponade, graft failure, and dysrhythmias — is rapidly fatal. Top 3 nursing priorities: 1. Hemodynamic stability — MAP 70–90 mmHg, CI >2.2 L/min/m² in the first 24 hours 2. Chest tube patency — mediastinal drainage must remain patent; sudden cessation of output in a bleeding patient signals tamponade 3. Neurological assessment — stroke is the most feared non-cardiac complication of cardiopulmonary bypass (CPB) Common NCLEX trap: Assuming decreased chest tube drainage = improvement. Sudden drop from 200 mL/hr to near zero in the early post-op period signals tube occlusion and impending cardiac tamponade — not hemostasis. On the exam, writers often pair stable-sounding options with unstable data—notice the mismatch before you commit. If...
