Post-coronary artery bypass graft entry and exit instructions

  After undergoing coronary artery bypass surgery, in order to prevent or delay the appearance of coronary artery lesions and blockage of bridge vessels to ensure the long-term efficacy of coronary artery bypass surgery. To do a good job in guiding and following up patients’ discharge care, understanding their cardiac function and systemic recovery, guiding their life and treatment, and facilitating their recovery as soon as possible after surgery is a follow-up work that should not be neglected, and it is important for postoperative patients to develop a healthy lifestyle.  I. Informed cooperation Strengthen communication during patient hospitalization, establish good nurse-patient relationship, and make patients and their families understand the knowledge of related diseases and daily life health care through health education according to patients’ gender, age, education level and living habits. Systematically guide patients’ life and treatment after admission, during surgery, after surgery and after discharge.  Patients should have a regular life after admission and discharge, quit smoking and drinking, ensure sufficient sleep, have a comfortable and quiet resting environment, keep the room at a suitable temperature and fresh air, increase and decrease clothes according to the climate, keep a happy mood, and pay attention to avoid triggers that cause angina pectoris. Such as excessive activity, overwork, emotional excitement, too much, cold, etc.. In particular, it is necessary to keep the bowel movement smooth, ensure 1-2 times/day, take laxatives if necessary, and avoid forceful bowel movement.  Diet During the recovery period, it is usually necessary to increase the intake of calories, protein, and vitamins. Coronary artery bypass grafting is only a treatment for myocardial ischemia caused by blockage of coronary arteries, but not a treatment for the cause of coronary heart disease. Therefore, attention to controlling hyperlipidemia in diet is one of the important measures to prevent and slow down the re-blockage of coronary arteries or after surgery. In daily life, we should pay attention to diet matching and scientific eating. Obese patients should reduce the total calorie intake, and high-fat patients should focus on low-fat diet. Eat less cholesterol-containing animal fat: such as animal liver, brain, kidney, caviar, cream, etc. Eat more food containing microorganisms: such as fresh green vegetables, fruits, and vegetable protein, especially soy protein, should be increased. If combined with hypertension or heart failure should adhere to a low-salt diet and limit salt intake.  Initially, you can walk around the room or the house, hold something when walking, and start walking when you feel no difficulty. Walking can improve blood circulation and increase the strength of muscles and bones. In the process of sports and exercise, if shortness of breath, asthma and fatigue occur, they should be stopped immediately.  V. Wound protection and treatment Within a few weeks of the surgery, the wound will have different degrees of pain and there is local is redness, after a period of time, the symptoms will disappear. Patients with coronary artery bypass graft usually have all openings in the legs. When resting or sitting, the lower limbs should be elevated to help reduce discomfort or swelling in the legs; or walk around frequently to facilitate blood return from the deep veins, thus reducing or avoiding swelling in the legs of the grafted vessels. If the wound in the chest or leg feels uncomfortable and there is severe pain, redness and swelling as well as discharge from the wound, you should go to the hospital as soon as possible. About a week after the stitches are removed, you can wash the wound with clean water and soap as long as it heals well, but keep the wound clean and dry. Do not swim and do throwing sports until the wound is completely healed, and do not use substances such as detergents and talcum powder locally on the wound.  VI. Work After 4 – 6 weeks after discharge from the hospital, consider the issue of returning to work based on the recovery of energy and physical strength after surgery and the time and tension of the work performed, if the workload is too heavy, you should switch jobs and pay attention to the combination of work and rest.  VII. Drug guidance After coronary artery bypass grafting, patients often need to continue taking vasodilators such as nitrates, calcium antagonists, betablockers, metoprolol, anticoagulants such as aspirin and clopidogrel, digitalis such as digoxin, etc. for a period of time. You should take your medication on time and in quantity as prescribed by your doctor, and you should not stop taking your medication at will, and you should pay attention to the side effects of your medication. When you go out, you should carry nitroglycerin drugs with you to prevent angina attacks. If the pain lasts longer than 30 minutes and the effect of the medication is not good, the occurrence of myocardial infarction should be considered and the nearest doctor should be consulted quickly so as not to delay the treatment and rescue time. If other diseases such as hyperlipidemia or hypertension are combined, it is necessary to insist on taking lipid-lowering and blood pressure-lowering drugs according to the doctor’s instruction in order to control the development of related diseases and ensure the full recovery after coronary artery surgery.  Review According to the treatment characteristics of coronary artery bypass surgery, we focus on the discharge guidance and post-discharge follow-up work while implementing psychological and physiological care, so that patients can not only get proper treatment and detailed and comprehensive examination before discharge, but also get early detection and timely treatment of possible problems after discharge to avoid complications and improve patients’ quality of life.  After discharge from the hospital, the review should be done once every half month, and then it can be gradually reduced to once every 1-2 months according to the condition, and a full review should be done once every 3-6 months after the operation.  We wish every patient a speedy recovery!