Question

A nurse is caring for a client who is 8 hr postoperative following a coronary artery bypass graft (CABG). Which of the following findings should the nurse report?

A. Incisional pain with movement
B. Serosanguinous drainage on the dressing
C. Blood pressure of 140/90 mmHg
D. Urine output less than 30 mL/hour

Answer 1

The nurse should report a urine output of less than 30 mL/hour following a CABG, as it could signal a significant issue such as renal insufficiency or failure.

Step-by-step explanation:

Important Clinical Considerations Following CABG Surgery

The nurse should report a urine output of less than 30 mL/hour, as this might indicate renal insufficiency or failure. Following a coronary artery bypass graft (CABG), it is expected for the patient to experience some incisional pain with movement and have serosanguinous drainage on their dressing, which may be normal in the immediate postoperative phase. A blood pressure of 140/90 mmHg is slightly elevated but may be acceptable in the acute postoperative setting, depending on the patient's normal readings and the context provided by additional clinical data.

However, the urine output should definitely be addressed. The expected urine output for an adult is at least 0.5 mL/kg/hour, and for most adults, this typically translates to more than 30 mL/hour. A decrease in urine output can be an early sign of kidney failure or inadequate perfusion, which could be life-threatening and warrants immediate attention and intervention from the health care team.