Coronary Artery Bypass Graft Flashcards, test questions and answers

Question 1

A nurse is assessing for cardiac Tampanode on a patient who had coronary artery bypass graft. Which of the following actions should the nurse take?

Answer

auscultate BP for pulsus paradoxus -pt w/ cardiac tamponade will have this when systolic BP is at least 10 mm Hg higher on expiration than on inspiration; this occurs b/c of sudden decrease in cardiac output from fluid compressing atria and ventricles -manifestations: d/t sudden decrease in cardiac output from fluid compressing atria and ventricles, hypotension pulsus paradoxus, and muffled heart sounds occur -check for cardiac tampondae by checking apical and radial pulses simultaneously to determine if rate is same; if different, indicates cardiac dysrhythmias
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Question 2

During coronary artery bypass graft (CABG) surgery, a male client with a history of chronic tobacco abuse experiences a dramatic decrease in his oxygen saturation. Subsequently, the client remains on a ventilator two days longer than anticipated. Which factor should the nurse consider when evaluating the client’s progress?

Answer

Variance- A variance is any event that may alter a pt’s progress through the clinical pathway, such as remaining on a ventilator for an additional two days
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Question 3

a nurse is caring for a client in the first 8 hr following coronary artery bypass graft (CABG) surgery. which of the following client findings should the nurse report to the provider? -mediastinal drainage 100mL/hr -blood pressure 160/80 mm Hg -Temperature 37.1 (98.9) -Potassium 3.8 mEq/L

Answer

blood pressure 160/80 mm Hg the nurse should report an elevated blood pressure following a CABG procedure because increased vascular pressure can cause bleeding at the incision sites.
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Question 4

6.ID: 809532937 A 71-year-old male patient who is currently undergoing coronary artery bypass graft (CABG) surgery has just experienced intraoperative vomiting. The nurse should consequently anticipate the use of which drug? Midazolam (Versed) Fentanyl (Sublimaze) Meperidine (Demerol) Ondansetron (Zofran) Correct

Answer

Ondansetron (Zofran) Correct Ondansetron (Zofran) is an antiemetic, whereas midazolam (Versed) is a benzodiazepine, and fentanyl (Sublimaze) and meperidine (Demerol) are opioid analgesics.
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Question 5

subjective -past medical hx: smoker, COPD, asthma, heart failure or MI in the past, lung cancer, stroke, pacemaker, pneumonia, bronchitis -past surgical hx: cardiac surgery, coronary artery bypass graft -chest pain: location; quality-sharp, dull; does it feel like a pressure; rate on scale of 0-10 -fatigue: have you been excessively tired lately; cells aren’t getting enough O2 -dyspnea: SOB, DOE-SOB on exertion -orthopnea: can’t breath when lying flat (3 pillow orthopnea) -cough: if yes, is it productive? if yes, how much sputum are you coughing up? copious amounts or a little, color and odor of sputum, blood (hemoptosis) -wheezing -allergies: food, seasonal -meds: what they take at home, anticoagulants, Digoxin, inhalers, anit-hypertensives, taking BP meds -infection: any recurrent respiratory infections

Answer

subjective data-tissue perfusion
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Question 6

A nurse is caring for a client who is scheduled for a coronary artery bypass graft (CABG) in 2 hr. Which of the following client statements indicates a need for further clarification by the nurse? A. “My arthritis is really bothering me because I haven’t taken my aspirin in a week.” B. “My blood pressure shouldn’t be high because I took my blood pressure medication this morning.” C. “I took my warfarin last night according to my usual schedule.” D. “I will check my blood sugar because I took a reduced dose of insulin this morning.”

Answer

C. “I took my warfarin last night according to my usual schedule.”
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Question 7

An OR nurse is preparing to assist with a coronary artery bypass graft (CABG). The OR nurse knows that the vessel most commonly used as source for a CABG is what? A) Brachial artery B) Brachial vein C) Femoral artery D) Greater saphenous vein

Answer

Ans: Greater saphenous vein Feedback: The greater saphenous vein is the most commonly used graft site for CABG. The right and left internal mammary arteries, radial arteries, and gastroepiploic artery are other graft sites used, though not as frequently. The femoral artery, brachial artery, and brachial vein are never harvested.
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Question 8

coronary artery bypass graft (CABG)

Answer

surgical technique to bring a new blood supply to heart muscle by detouring around blocked arteries
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Question 9

The OR nurse is explaining to a patient that cardiac surgery requires the absence of blood from the surgical field. At the same time, it is imperative to maintain perfusion of body organs and tissues. What technique for achieving these simultaneous goals should the nurse describe? A) Coronary artery bypass graft (CABG) B) Percutaneous transluminal coronary angioplasty (PTCA) C) Atherectomy D) Cardiopulmonary bypass

Answer

Ans: Cardiopulmonary bypass Feedback: Cardiopulmonary bypass is often used to circulate and oxygenate blood mechanically while bypassing the heart and lungs. PTCA, atherectomy, and CABG are all surgical procedures, none of which achieves the two goals listed.
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Question 10

The nurse receives report from the previous shift. Which of the following patients should the nurse see FIRST? 1. A patient post coronary artery bypass graft (CABG) having the atrioventricular (AV) wires removed later in the day. 2. A patient with type 1 diabetes scheduled for a cardiac catheterization later today. 3. A patient 1 day postoperative with an epidural catheter in place. 4. A patient diagnosed with cardiomyopathy being evaluated for a heart transplant.

Answer

(1) although the patient requires a high level of nursing care, no indication that the patient is unstable (2) patient requires preoperative assessment and teaching, no indication that the patient is unstable (3) correct —epidural used for pain relief, monitor for urinary incontinence, hypotension, respiratory depression, and nausea and vomiting (4) requires monitoring but patient with epidural takes priority
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