Michael Martin

Open Heart Observation Journal → 11/3/2022

Today in the operating room I observed a CABG procedure. This procedure was

performed to fix a blocked artery. This procedure takes the great saphenous vein from the leg,

which is the longest vein in the body, and grafts it from the aorta to the coronary artery to bypass

the blockage and restore better blood flow to the heart. At some point during the procedure, the

heart is stopped with IV potassium so that the surgeon can stitch parts of the great saphenous

vein to the heart. The purpose of the cardiopulmonary bypass machine is to perfuse the body

with oxygenated blood while the heart is in asystole and not moving. One potential ethical

concern related to open-heart surgery could be not properly informing the patient before getting

consent. I wasn’t able to locate nursing management priorities in the High-Acuity Nursing

textbook by Wagner on page 456. However, I do know from my experience today that it is

important for nurse to preoperatively draw up blood for a blood count, and to also make sure the

patient understands the importance of completing scheduled appointments with the surgeon in

the weeks prior to the procedure. Postoperatively, the nurse should keep the patient on

continuous pulse oximetry, monitor ABG’s, and get the patient up and moving as early as

possible. Overall, I believe this clinical may have been my favorite clinical rotation throughout

my entire academic career. The nurse allowed me to insert a foley catheter into the patient after

he was put under by anesthesia. I felt really comfortable and welcomed in the OR because the

cardiac surgical team was a very pleasant group to work with. Not to mention, they were all

really experienced and knowledgeable.