CABG surgery involves taking a vein or artery from the leg or chest and grafting it to bypass blockages in the coronary arteries. It is primarily done to relieve chest pain and improve survival for patients with severe coronary artery disease. Nursing management includes preoperative teaching, monitoring the patient during surgery, and postoperative care like managing pain, maintaining fluid and electrolyte balance, and teaching self-care activities.
Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. It's used for people who have severe coronary heart disease (CHD), also called coronary artery disease.
Nursing management of patient with cardiac surgeries.PrashantSalve10
It will be helpful to overview cardiac surgeries like CABG, Valvular surgeries and heart transplant. It also enumerates the nursing diagnoses and its brief description.
Mitral valve replacement is a procedure whereby the diseased mitral valve of a patients heart is replaced by either a mechanical or tissue(bioprosthetic )valve.’
Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. It's used for people who have severe coronary heart disease (CHD), also called coronary artery disease.
Nursing management of patient with cardiac surgeries.PrashantSalve10
It will be helpful to overview cardiac surgeries like CABG, Valvular surgeries and heart transplant. It also enumerates the nursing diagnoses and its brief description.
Mitral valve replacement is a procedure whereby the diseased mitral valve of a patients heart is replaced by either a mechanical or tissue(bioprosthetic )valve.’
CARDIAC TAMPONADE ( Cardiac emergency) • Cardiac Tamponade is a life threatening complication caused by excessive accumulation of fluid in the pericardium. Or • Compression of all cardiac chambers due to excessive accumulation of pericardial fluid leading to compromised cardiac out put.
The CVP catheter is an important tool used to assess right ventricular function and systemic fluid status. Normal CVP is 2-6 mm Hg. CVP is elevated by : overhydration which increases venous return.
CARDIAC TAMPONADE ( Cardiac emergency) • Cardiac Tamponade is a life threatening complication caused by excessive accumulation of fluid in the pericardium. Or • Compression of all cardiac chambers due to excessive accumulation of pericardial fluid leading to compromised cardiac out put.
The CVP catheter is an important tool used to assess right ventricular function and systemic fluid status. Normal CVP is 2-6 mm Hg. CVP is elevated by : overhydration which increases venous return.
Transcultural nursing topic is very important for nursing students. Transcultural nursing is a comparative study of cultures to understand similarities (culture universal) and difference (culture-specific) across human groups.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
6. Coronary Artery Bypass
Graft
•CABG surgery involves anastomosis of a
graft (leg & arm veins)anastomosed to the
aorta, with the other end of the graft
secured to a distal portion of a coronary
vessel. The graft “bypass” the obstructive
lesion in the vessel,& adequate blood flow is
restored to the heart muscles supplied by
the artery.
7. Cont…..
a.Multiple a grafts can be placed to bypass
lesion.
b.Traditional procedure is done through
sternotomy.
c.The heart is stopped, & the
cardiopulmonary bypass machine is used
• Primarily done to alleviate anginal
symptoms and improve survival.
8. Indications for CABG
•Left main coronary artery stenosis of 50%
or more.
•50% stenosis of three main coronary
arteries.
•Unstable angina.
•Chronic stable angina unresponsive to
medical therapies or PTCA and stenting.
9. Relative contraindications
for CABG
•Small coronary arteries distal to stenosis.
•Severe aortic stenosis.
•Severe left ventricular failure with
coexisting pulmonary, renal, carotid,&
peripheral vascular diseases.
10. MIDCAB
•Done through a left anterior small
thoracotomy, or a small incision using a port
access and video-assisted technology.
•Cardiopulmonary bypass is not needed
because the heart remains beating.
•The procedure is limited to proximal
disease of the left anterior descending or
right coronary artery.
11. Off-pump CABG
•CABG surgery is done using a median
sternotomy without the use of
cardiopulmonary bypass.
•Preferred method in patient with poor
ventricular function or with severe aortic
atherosclerosis.
20. Teach chest physical procedure
to optimize pulmonary function.
Prepare patient for presence of
monitors, chest tubes, I.V lines,
blood transfusion,ET tube, NG
tube, arterial line, & indwelling
catheter.
•Preparation of events in the
postoperative period
Take family & patient on tour
of ICU
Cont…..
21. Cont…..
Discuss with the patient the need
to monitor vital signs frequently &
the likelihood of frequent
disturbances of the patient’s rest.
Discuss pain management with
patient.
Tell patient that both hands may
be loosely restraint for few hours.
22. Cont…..
•Evaluation of emotional state
•Surgical preparation:
Shave anterior & lateral surfaces
of trunk & neck; shave entire body
down to ankles.
Shower or bathe per policies.
23. NURSING DIAGNOSIS
•Fear related to surgical procedure, its
uncertain outcome, and the threat of
well-being.
Goal: To reduce fear.
25. INTERVENTIONS
•Allowing patient and family to express their
fears.
•Explain the patient regarding surgery and
sensations that are expected during and
after the surgery.
•Reassuring the patient that fear of pain is
normal and explain that some pain will be
experienced but certain measures will help
to relieve the pain.
26. Cont….
•Encourage the patient to talk about the
fear of dying.
•Patient should be reassured and
misconceptions should be corrected
27. Nursing Diagnosis
•Knowledge deficit regarding the surgical
procedure and the postoperative course.
Goal: To provide the knowledge
regarding surgery
29. Interventions
Patient and family teaching about
•Hospitalization
•Surgery
•Length of surgery
•Expected pain and discomfort
•Critical care phase
•Recovery phase
30. Cont…..
•Medications before surgery
•Physical preparation before surgery
•Information regarding equipments, tubes
that will be present postoperatively
•Teaching the postoperative exercises.
•Outcome of the surgery
31. Nursing Diagnosis
•Potential for complications related to the
stress of impending surgery (Angina, Severe
anxiety, Cardiac arrest)
Goal: To monitor and manage the
complications
37. Cont…..
•Monitor fluid & electrolyte balance.
•Postoperative medications
Aspirin daily as MI prophylaxis.
Analgesics.
Antihypertensives or
antiarrhythmics as needed.
•Monitor for complications.
40. Cont…..
•Monitor urinary output
•Feel the skin; note temperature & color
of extremities.
•Monitor neurological status
Observe for symptoms of
hypoxia
Observe mental status, body
movements or reflexes
Monitor for & treat post
operative seizures
41. Nursing diagnosis
• Risk for impaired gas exchange
related to trauma of extensive chest
surgery
Goal: To maintain adequate gas
exchange
42. Interventions
• Frequently monitor function of
mechanical ventilator
• Check ET tube placement
• Auscultate chest for breath sounds
• Promote coughing & deep breathing
exercises
• Suction tracheobronchial secretions
carefully
43. Cont….
• Restrict fluid for first few days
• Monitor arterial blood gases, tidal
volumes, peek inspiratory pressures
and extubation parameters
• Provide chest physiotherapy as
prescribed
45. Nursing diagnosis
• Risk for alteration in fluid volume and
electrolyte balance related to
alteration in blood volume
Goal: To maintain fluid and electrolyte
balance
46. Interventions
• Administer I.V fluids as ordered
• Maintain intake & output chart
• Be alert to changes in serum
electrolyte
47. Nursing diagnosis
• Pain related to operative trauma and
pleural irritation caused by chest
tubes
Goal: To relieve pain
48. Interventions
• Record nature, type, location,&
duration of pain.
• Assist patient to position of comfort
• Differentiate between incisional pain
& anginal pain
• Administer medications as prescribed
49. Nursing diagnosis
• Risk for hypothermia/hyperthermia
related to cardiopulmonary bypass
surgery, infections etc.
Goal: To maintain normal body
temperature
50. Interventions
• Assess for elevated body temperature
• Assess for dysrythmias due to
hypothermia
• Assess for infection ( lungs, urinary
tract, incisions and intravascular
catheter )
• Use the aseptic technique while
dressing and other procedure
51. Cont…..
• Using proper hand washing technique
• Meticulous care to be taken to
prevent contamination at the sites of
catheter and tube insertion
• Care of the graft donor site.
54. Nursing diagnosis
• Knowledge deficit about self care
activities
Goal: to help the patient in the
performance of self care activities
55. Interventions
• Develop teaching plan for patient and
family specifically about:
• Diet
• Activity progression
• Exercise
• Deep breathing, coughing exercises
• Medication regimen
• Follow up
