摘要:

The cardiovascular surgical patient presents great challenges in terms of patient management. As the specialty has grown since its earlier days, so have the strategies for patient management and related nursing practice. This article examines four controversial topics related to postoperative management of those patients: treatment for atrial fibrillation, antithrombotic therapy, replacement fluid management, and issues related to advanced nursing practice. Three of those topics, although having a medical focus, augment the nursing knowledgebase and provide assistance in independent decision making. The fourth topic reviews issues related to extended practice within the staff nurse role.

ISSN:0889-4655    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A pilot program was conducted in an effort to understand the advantages of admitting patients requiring cardiac surgery on the day of the scheduled surgical procedure. A total of 143 patients over a 4-month period were admitted on the day of surgery. Patients required repair of atrial septal defect (adult), coronary artery bypass grafts, and/or heart valve replacements.Patients, family members, and significant others verbalized positive feelings about the program. Both nurses and physicians assert that a high quality of patient care was rendered through this program. Additionally, the institution realized some financial gain by reducing the length of stay for each patient by at least 1 day.

ISSN:0889-4655    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Case management is a nursing model that hospital administrators have implemented in an effort to reduce costs and improve quality. The pivotal tool that case management utilizes to standardize treatment plans, trend deviations from the standard, and document care is the critical pathway. Proper development, implementation, and utilization of critical pathways provide health care professionals and administrators with quantitative data on correlations between effective resource utilization and patient outcomes.

ISSN:0889-4655    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The average age of patients undergoing coronary artery bypass grafting (CABG) has increased. To determine influence of age on postoperative course, the authors reviewed the outcome of 199 consecutive patients who underwent primary, isolated, elective CABG. The 101 patients <65 years (group I) and 98 patients ≥65years (group II) were similar in preoperative severity of symptoms, history of myocardial infarction, number of grafts received, and time on cardiopulmonary bypass. Comparison between the two groups revealed similar rates of operative mortality and morbidity. In group II patients, median rates of hospitalization and intensive or intermediate care unit stay were greater (P<0.005), and there wore significantly higher incidences of postoperative disorientation, transfusion of exogenous blood, and need for special discharge arrangements (P< 0.05). The authors conclude that CABG patients ≥ 65 years of age have a longer and more complex postoperative course than younger patients and suggest that further nursing research bo conducted to identify the specific needs of this patient population.

ISSN:0889-4655    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Diabetic patients comprise a significant portion of the overall number of coronary artery bypass graft surgery patients. These patients are at greater risk to develop complications postoperatively because of associated changes in their cardiovascular system. Diabetic patients may respond differently to cardiac surgery if they have autonomic neuropathy, microvascular changes, and macro vascular disease Nurses must be aware of the effect of diabetes on the cardiovascular system and how this can affect patient recovery.

ISSN:0889-4655    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Postoperative bleeding is caused by alterations in the normal process of hemostasis or by a surgical problem. The role of platelets, coagulation proteins, and fibrinolysis in the control of postoperative bleeding is re viewed, as are preoperative and intraoperative factors that interfere with these normal processes. Current treatment of postoperative bleeding is discussed, including the use of positive end-expiratory pressure, control of hypertension, medication, and blood products.

ISSN:0889-4655    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Positioning critically ill patients is a frequently used intervention in nursing practice. However, positioning can have a beneficial or adverse effect depending on the effect on oxygen delivery and oxygen consumption. This article examines the physiologic effect of positioning on the balance between oxygen delivery and oxygen consumption. In addition, a critical analysis of the research on the effect of positioning on mixed venous oxygen saturation is presented. Recommendations for patient management are discussed as well as the implications for future research.

ISSN:0889-4655    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Sternal wound complications after cardiac surgery occur in 0.4% to 8% of mortality rate as high as 27%. Treatment varies and does not always yield favorable article discusses normal wound healing versus healing by secondary intention. factors that delay healing are highlighted. A case study describes the utilization absorption dressing to promote the healing process in a sternal wound treatment modality proved to bo effective as a nontraditional approach to healing intention.

ISSN:0889-4655    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The hallmark for recovery from cardiac surgery may be the full return to social and sexual activity. Three studies are reviewed that examine the level of social and sexual adjustment at three points in time following surgery: 4 to 10 weeks, 3 to 6 months, and 12 months. Implications for practice and further research are discussed.

ISSN:0889-4655    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0889-4655    

出版商:OVID    

年代:1993

数据来源: OVID