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When evaluating the effectiveness of preoperative teaching with a client scheduled for coronary artery bypass graft (CABG) surgery using the internal mammary artery, the nurse determines that additional teaching is needed when the client says which of the following?

A.

"They will circulate my blood on a machine during the surgery."

B.

"I will need to take an aspirin every day after the surgery to keep the graft open."

C.

"They will use an artery near my heart to go around the area that is blocked."

D.

"I will have small incisions in my leg where they will remove the vein."

Answer and Explanation

The Correct Answer is D

A. "They will circulate my blood on a machine during the surgery.": This is correct information regarding the use of a heart-lung machine during CABG.

B. "I will need to take an aspirin every day after the surgery to keep the graft open.": Daily aspirin therapy is standard to prevent graft occlusion, indicating correct understanding.

C. "They will use an artery near my heart to go around the area that is blocked.": This accurately describes using the internal mammary artery for the bypass, showing correct knowledge.

D. "I will have small incisions in my leg where they will remove the vein.": This indicates confusion, as the internal mammary artery, not leg veins, is used in this type of CABG.


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Related Questions

Correct Answer is D

Explanation

A. Administering multiple vitamins and minerals via IV alone would not be sufficient for adequate nutrition in this patient, especially given the large burn surface area.

B. Total parenteral nutrition (TPN) may be used if enteral feeding is not possible, but enteral feeding is usually preferred when feasible.

C. Encouraging oral intake is not appropriate for a client with a 60% TBSA burn, as they would likely require more significant nutritional support than oral intake can provide.

D. Enteral feeding is the preferred method for nutrition in burn patients as it maintains gut integrity and prevents the complications associated with parenteral nutrition. Although the client has absent bowel sounds and a distended abdomen, this can be common early in burn care, and enteral feedings should be started as soon as feasible to prevent malnutrition and promote recovery.

Correct Answer is D

Explanation

A. Increasing IV fluids would exacerbate the client's fluid overload and worsen heart failure symptoms.

B. Trendelenburg positioning is typically used for shock management, but this client’s fluid overload needs to be addressed first.

C. Monitoring is important but does not address the immediate need to manage fluid overload.

D. The client's elevated CVP, PAWP, and BNP levels indicate fluid overload and heart failure with reduced ejection fraction. The priority is to reduce fluid overload by administering IV diuretics, which will help reduce the pressure in the heart and lungs, improving oxygenation and decreasing the risk of pulmonary edema.

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