Cuidados de enfermagem em cirurgia cardíaca
Autor: Adm. Blog | Publicado: 2016-06-11T08:00:00-03:00

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A cirurgia do coração aberto
é mais comumente realizada para a doença da artéria coronariana, disfunção
valvular e defeitos cardíacos congênitos.



Conduta
pré – operatória/cuidados de enfermagem



· Rever a doença do paciente
para determinar o estado dos sistemas pulmonar, hepático, hematológico e
metabólico.

· Obter estudos
laboratoriais pré-operatórios.

· Avaliar os esquemas
medicamentosos; digital, diuréticos, Bloqueadores beta-adrenérgicos,
psicotrópicos, anti-hipertensivos, álcool, anticoagulantes, corticosteróides,
antibióticos profiláticos.

· Melhorar a doença pulmonar
subjacente e a função respiratória para reduzir o risco de complicações.

- Estimular o paciente a
interromper o fumo.

- Tratar a infecção e a congestão
pulmonar vascular.

· Preparar o paciente para
os acontecimentos no período pós – operatório.

· Avaliar estado emocional
do paciente e tentar diminuir as ansiedades.

· Preparação cirúrgica.



Conduta
pós-operatória/cuidados de enfermagem



· Garantir uma oxigenação
adequada no período pós-operatório imediato à insuficiência; a insuficiência
respiratória é comum após a cirurgia de coração aberto.

· Empregar a monitorização
hemodinâmica durante o período pós-operatório imediato, para avaliar o estado
cardiovascular e respiratório e o equilíbrio hidroeletrolítico, no sentido de
evitar complicações ou reconhecê-las o mais cedo possível.

· Monitorar a drenagem dos
drenos torácicos mediastinais e pleurais.

· Monitorar rigorosamente o
equilíbrio hidroeletrolítico, pode ocorrer a acidose metabólica e o equilíbrio
eletrolítico depois do uso de um oxigenador de bomba.

· Administrar medicamentos
pós-operatórios.

· Monitorar quanto a
complicações.

· Instituir o marcapasso
cardíaco se indicado através dos fios do marcapasso temporário.



Intervenções
de enfermagem



· Minimizar ansiedade;

· Promover uma troca gasosa
adequada;

· Manutenção do débito
cardíaco adequado;

· Mantendo o volume adequado
de líquido;

· Aliviar a dor;

· Promover a orientação
perceptiva e psicológica;

· Outras responsabilidades
de enfermagem evitando complicações.

&nbsp;Arritmias

Tamponamento cardíaco

&nbsp;IM

&nbsp;Embolização

Sangramento

&nbsp;Febre/infecção

&nbsp;Insuficiência renal



Fonte:&nbsp; BRUNNER &amp;
SUDDARTH. Tratado de enfermagem médico – cirúrgico. 9ª ed. Rio de Janeiro;
Guanabara Koogan: 2002.



- NETTINA. Prática de
Enfermagem. 6ª ed. Rio de Janeiro; Guanabara Koogan: 1996.