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How to Write a Summary of an Article? Post-CABG Nursing Coronary heart disease is a major physical illness and one of the main causes of death in Western society People who do not die an early and sudden death may have to consider a major surgical treatment, the most prevalent being coronary artery bypass graft surgery CABG.
More thansuch operations are performed annually in the United States alone. In this paper, we will discuss the postoperative complications of CABG and how they impact nursing practice. Such outcomes can be accounted for by illness severity factors. Barbut D, Hinton et al. Of all the adverse neurological outcomes that may be incurred postoperatively, stroke is one of the most serious.
However, due to technological and surgical improvements the incidence of stroke is Postoperative cabg depression essay reported to be as low as between 0.
Neuropsychological research suggests, however, that a considerable proportion of all patients who undergo CABG sustain some degree of cerebral damage and that this manifests as mild cognitive impairment.
Although these cognitive deficits rarely disturb activities of daily living, they are still considered cause for concern. Therefore, it is these less severe forms of neurological injury, which are now targeted for reduction in what has been described as an age of quality improvement Stump D.
Cognitive impairment following coronary artery bypass grafting, Neuropsychological tests are valuable tools in the assessment of brain dysfunction as they provide a method of systematically and quantitatively studying the behavioral expressions of this dysfunction Lezak, As there is now only a low risk of stroke following CABG, milder forms of cerebral damage have become a greater focus of concern.
Consequently, neuropsychological assessment has become more important within the domain of cardiac surgery. The advantage of neuropsychological tests is that they are capable of detecting subtle changes in cognitive function. In comparison, conventional neurological assessment techniques, such as the Mini-Mental State Examination, are less sensitive and therefore less able to detect subtle CNS changes In addition, neurological assessment techniques do not lend themselves as readily to quantitative analysis [Heyer E.
In this way, intersubject variability is minimized as the subjects act as their own controls. While cognitive deficits have been consistently reported in the immediate postoperative period, some researchers have readministered test batteries in the immediate postoperative period, typically within 5—10 days of surgery Aris A, et al, ; Clark et al.
Hospital stays often are prolonged due to intermittent hemodynamic instability of thomboembolic complications. During AF, loss of synchronous atrial mechanical activity response, and inappropriately high heart rates may have adverse effects o n hemodynamic functions and cause hypotension and hear failure.
Risk of postoperative stroke has been found to be significantly increased with postoperative atrial tacharrhymias. Atrial effective refractory periods ERP has been used a parameter to evaluate atrial repolarization and ERP and its dispersion are known parameters of atrial vulnerability that indicate enhanced atrial arrhythmogenesis, include a history spontaneous paroxysmal AF and easy inductility of atrial arrhthmias.
Most of these effusions are small, self-limiting and do not require interventions. However, chronic, persistent post-CABG effusions have been reported.
The etiology of these persistent effusions remains unknown. Lee et al, Sleep disturbances is another big postoperative complication The purpose of a Schafer et al study was to describe the nature and frequency of sleep pattern disturbances in patients post coronary artery bypass CABG surgery.
An exploratory design using telephone interviews at one week, one month, three months and six months was used to describe the incidence and nature of sleep disturbances post CABG surgery.
Forty-nine patients completed all four measurement times. More than half of the patients reported sleep disturbances at each measurement time.
Coronary Artery Bypass Grafting (CABG) University: Date: Coronary artery bypass grafting, abbreviated CABG, is a kind of surgery that enhances the flow of blood flow to the heart in people suffering from coronary artery disease, also known as severe coronary heart disease (CHD). Especially strong correlations exist between postoperative depression and heart surgery, gastric bypass surgery, and plastic surgery procedures. Studies also implicate brain surgery, hip replacement surgery, mastectomy, radical prostatectomy, hysterectomy, cancer resection, and even vision-correction surgery in postoperative depression. To describe the relationship between pain and depression on recovery after coronary artery bypass grafting (CABG). Methods A secondary data analysis on depressed and nondepressed post-CABG patients enrolled in a randomized, controlled, effectiveness trial of telephone-delivered collaborative care for depression.
Sleep disturbances during the first month post CABG were reported to be the result of incisional pain, difficulty finding a comfortable position and nocturia.
Although less frequent over time, these problems persisted for six months. Miller et al discusses post CABG postoperative symptoms. At 1 week post-CABG, symptoms were incisional pain, wound drainage, chest congestion, shortness of breath, dizziness, sweating, swollen feet, and loss of appetite; incisional pain and swollen feet were reported by a few patients at 6 weeks after CABG.
The incidence and frequency of postoperative symptoms declined over time. There were several age-related differences in symptom reports prior to and at 1 and 6 weeks after the procedure Miller et al, Nursing interventions A wide variety of interventions have been tested for recovery of CABG patients.
These 19 studies tested 20 interventions.
Most of the interventions were educational in nature and dealt with preoperative or discharge instructions or counseling provided to patients. Preoperative interventions to affect in-hospital recovery included preparatory information about cognitive dysfunction following surgery, preparatory information and counseling about physical and psychologic recovery, and psychiatric counseling.
Interventions for home recovery were delivered close to the time of discharge or within the first couple of weeks following discharge. Another study tested an education program that included a behavioral component as well Various outcome variables have been used to evaluate CABG recovery.
The most frequently used outcome was mood states; 10 of the 19 studies used mood states as an outcome measure. The most frequently used measurement point for hospital recovery outcomes was the first day following surgery and discharge.
Home recovery outcomes were usually measured at 1, 3, and 6 months following discharge. Outcomes associated with risk factor modification most often were measured at 6 weeks and 3, 6, and 12 months following surgery.CABG.
Depression after CABG increases both the risk of poor physical and emotional recovery from surgery3,11 and the morbidity and mortality from cardiovascular disease Postoperative depression hasbeen associatedwithdecreased.
Postoperative care is the care you receive after a surgical procedure. The type of postoperative care you need depends on the type of surgery you have, as well as your health history. Objective: Depression is highly comorbid with coronary artery disease. Clinicians face the question of whether patients’ depressive symptoms will improve after coronary artery bypass graft surgery (CABG).
The objective of this meta-analysis is to determine the course of depressive symptoms after CABG. Methods: EMBASE, PubMed, and PsycINFO were searched for studies assessing depression before . This essay provides an overview of postpartum depression, the impact it has on the individual client, the newborn, and the family, the physical and mental assessment findings, and its impact on my future nursing practice.
Depression Teresa Collick HCA/ April 24, Depression has always been a major health issue going back for many years. Initially being called “melancholia” it appeared in the texts of the Mesopotamians in the second millennium.
Identifying depression in CABG patients is important in view of the high comorbidity of depression in those with coronary artery disease, the negative effect of depression on postoperative recovery, morbidity, and mortality, and the treatability of depression.