Friday, March 26, 2010

Care For Elderly Cardiac Bypass Patients

While open-heart surgery can improve the quality of life for elderly individuals, survival rates, possible complications and return of symptoms must be carefully evaluated before making the decision to operate. Yet more elderly patients today are undergoing cardiac surgery. Although not every older person is a candidate for this type of surgery, routine follow-up care after bypass surgery can affect an elderly patient's overall recovery. With proper postoperative care, older individuals are now recovering from cardiac bypass surgery just as well as younger patients.


Instructions


1. Schedule a comprehensive preoperative assessment to gather the information needed to adequately plan for the patient's care following surgery. This is especially important for those individuals who have multiple medical problems and run a greater risk of complications from surgery. A preoperative assessment allows the doctor and other members of the patient's health care team to identify potential problems beforehand.


2. Plan for what mobility aides a patient may need throughout the recovery process. Knowing in advance what assistive devices a patient will need during hospital admission can speed recovery by helping him to regain his normal level of functioning sooner.


3. Note the patient's medical history. Other medical conditions such as diabetes or hypertension can delay postoperative recovery. Being prepared can lead to early interventions to avoid more serious complications.


4. Take the steps necessary to minimize the risk of skin breakdown. According to an article published in the American Journal of Critical Care, pressure sores are a major problem for elderly patients after cardiac surgery. The goal of the nursing team is to intervene and prevent ulcers from forming or from progressing to a more serious stage. The condition of the patient's skin should be assessed at the time of admission, and thereafter, at least every 12 hours from the first until the fifth day of postoperative care. Examples of interventions include keeping skin clean, dry and moisturized, turning patients in bed at least every 2 hours and making sure the patient is eating properly.


5. Perform the mini-mental state exam to assess the elderly patient's cognitive abilities prior to surgery. Unfortuntely, depression is common in patients following bypass surgery. A study published in the April 2009 issue of Archives of General Psychiatry shows that approximately 20 percent of individuals who undergo coronary artery bypass surgery experience severe depression afterward. If a patient is already depressed before the surgery, researchers say that recovery usually takes longer in addition to a higher risk of complications following surgery.








6. Educate the patient and her family about what to expect after surgery, as this can help to reduce the patient's anxiety about the surgery. Older patients need to be informed that postoperative confusion can occur along with other potential risk factors and complications such as disrupted sleep, hospital infections and pulmonary embolisms caused by being in bed after surgery.

Tags: bypass surgery, after surgery, cardiac surgery, elderly patient, elderly patients, every hours, following surgery