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LPN ~ Introductory Medical-Surgical Nursing I- Cardiovascular surgery

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LPN ~ Introductory Medical-Surgical Nursing I- Cardiovascular surgery

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LPN INTRODUCTORY MEDICAL SURGICAL
NURSING 1 CARDIOVASCULAR SURGERY



Cardiopulmonary bypass (extracorporeal circulation): - ANSWER-Mechanically
circulating and oxygenating blood outside of the body while the beating heart is
stopped


Cardiopulmonary bypass Disadvantages: - ANSWER-long operative period,
anticoagulation, hypotension, risk for stroke, dysrhythmia


Myocardial Revascularization: - ANSWER-Coronary Artery Bypass


Coronary Artery Bypass Indications: - ANSWER-Client has multiple coronary
artery occlusions. Atheromas are calcified and noncompressible. Anatomic location
of the occlusion interferes with the safe insertion of a coronary artery catheter.


Coronary Artery Bypass Procedure: - ANSWER-Bypassing or detouring around
the occluded portion of one or more coronary arteries with a relocated blood vessel


Graft vessel: - ANSWER-saphenous vein


Alternate graft vessel: - ANSWER-internal mammary, internal thoracic arteries,
basilic, cephalic vein in arm, radial artery, gastroepiploic artery from stomach

, Conventional Coronary Artery Bypass Graft (CABG): - ANSWER-Procedure:
attach harvested saphenous vein to aorta or below the occlusion


CABG Types: - ANSWER-double, triple, or quadruple


Off-Pump Coronary Artery Bypass (OPCAB): - ANSWER-No use of
cardiopulmonary bypass machine; adenosine (Adenocard) used to slow heart rate.
Instruments lift and stabilize graft vessels on anterior, lateral, and posterior wall of
beating heart.


OPCAB Advantage: - ANSWER-reduced mortality rate, fewer postoperative
complications, decreased postoperative recovery time


Minimally Invasive Direct Coronary Artery Bypass (MIDCAB): - ANSWER-
Procedure: endoscopic view of heart and grafting vessels through small incision
between the ribs


MIDCAB Limitations: - ANSWER-only one or two vessels grafting


Port access coronary artery bypass (PACAB) aka TECAB: - ANSWER-Procedure:
uses cardiopulmonary bypass machine attached to femoral artery and vein rather
than great vessels of heart. Triple lumen vascular catheter inserted via
thoracoscope; video camera and transesophageal echocardiography to visualize
operative area


Valve Repairs and Replacements Commissurotomy: - ANSWER-opening
adhesions in the valve cusps; thoracotomy

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