Case Study, Chapter 17, Preoperative Nursing Management
Joan Arnold, 67 years of age, is a female patient who underwent a coronary angiogram
that diagnosed severe coronary artery disease in three of her coronary arteries, the left
anterior descending, the left circumflex, and the right coronary artery. She is scheduled for
a coronary artery bypass graft operation tomorrow. The nurse provides patient education
for Mrs. Arnold and her husband, which includes watching a hospital video on the
operation, the intensive care environment, what to expect after the surgery, the recovery
period, and cardiac rehabilitation. The video also covered the importance of coughing and
deep breathing, using an incentive spirometer, splinting, early ambulation, pain
medication, and how to position oneself safely. The video stressed the importance of not
rolling onto the side that the chest tube may be in place postoperatively. The video also
discussed the preoperative preparation. The nurse also provided a booklet on the subject
material. The nurse had a session with the patient and her husband to assess their
understanding and to answer any questions they may have had. (Learning Objectives 6 to
8)
a. What specific preoperative nursing measures should the nurse review with the patient to
help decrease the risk for postoperative complications?
1. Explain the role of the nurse when implementing the immediate preoperative
preparation the day before surgery and the morning of the surgery?
