DAY BEFORE SURGERY

• Surgeon
• PA/NP
• Anesthesiologist
• Mended Hearts
• Research Nurse

• Exidine shower at bedtime or in the a.m.

• Stop aspirin or NSAIDS
• Sleeping pills available if needed

• Eat what you like for dinner, but nothing by mouth after midnight except medications.

• Unrestricted activity

• Complete home needs assessment

• This plan of care
• Review advance directives
• Breathing/coughing exercises and IS (Incentive Spirometer)

DAY OF SURGERY/ICU

• Surgeon
• PA
• Anesthesiologist
• Mended Hearts

• Breathing tubes
• Tube for stomach
• Catheter for urine
• Chest tubes
• IV lines
• Pacer wires
• Heart monitor

• Breathing tube removed
• Tube for stomach removed
• IV lines capped

• IV fluids
• Pain medication if needed

• Nothing by mouth
• Ice chips and sips of clear liquids if breathing tube is out

• Bed rest
• Wrists will be loosely restrained to protect breathing tube
• IS every hour while awake if breathing tube is out
• Dangle legs on side of bed
• If breathing tube is out and is able to dangles, transfer to Cardiac Telemetry Unit

• Family orientation to ICU
• Nurse will update your family
• Education reinforced as needed

DAY 2 AFTER SURGERY

• Surgeon
• PA
• Mended Hearts

• Breathing tubes
• Tube for stomach
• Catheter for urine
• Chest tubes
• IV lines
• Pacer wires
• Heart monitor

• Breathing tube removed
• Tube for stomach removed
• Catheter for urine removed
• Chest tubes removed
• IV lines capped

• Ask for pain medication and sleeping pill if needed
• Valve patients begin Coumadin

• Sips of liquids after breathing tube out
• Solid foods when ready, then Healthy Heart Diet

• Sit on side of bed
• Up in chair 1-2 times
• Walk with assistance to bathroom
• Feed self
• Daily weight and measure urine
• IS every hour while awake
• Transfer to Cardiac Telemetry Unit

• Discuss discharge, social and nutrition needs with nurse

• Receive discharge instruction packet

DAY 2 AFTER RECOVERY

• Surgeon
• PA
• Mended Hearts

• Chest tubes
• Pacer wires
• Heart monitor
• Catheter for urine removed

• Remove chest tubes
• Remove bandages
• Dial soap and water to incisions
• Remove pacer wires
• Remove catheter for urine

• Ask for pain medication and sleeping pill

• Healthy Heart Diet

• Up in chair
• Walk in hall 1-3 times, 100-200 ft.
• Weight and measure urine
• Feed self
• Bathe at sink with assistance
• IS every hour while awake

• Discuss discharge, social and nutrition needs with nurse

• Read and review discharge instruction packet
• See home recovery video on hospital TV Channel 12 at 1:00 and 7:00 p.m.

DAY 3 AFTER SURGERY

• Surgeon
• PA
• Mended Hearts

• Pacer wires
• Heart monitor

• Stop heart monitor
• Remove pacer wires
• Remove capped IV

• Ask for pain medication and sleeping pill
• Ask for laxative if needed

• Healthy Heart Diet

• Up in chair
• Walk in hall 3-4 times, 200-400 ft.
• Weight and measure urine
• Feed self
• Shower
• IS every hour while awake
• Late morning discharge

• Driver designated and clothes at bedside for home

• Review packet and see film
• Review medications
• Receive prescriptions and appointment schedule

DAY 4 AFTER SURGERY

• Surgeon
• PA
• Mended Hearts

• Pacer wires
• Heart monitor

• Stop heart monitor
• Remove pacer wires
• Remove capped IV

• Ask for pain medication and sleeping pill
• Ask for laxative if needed

• Healthy Heart Diet

• Morning discharge (9 a.m.)
• Up in chair
• Walk in hall 3-4 times, 200-400 ft.
• Weight and measure urine
• Shower
• IS every hour while awake

• Driver designated and clothes at bedside for home

• Review packet and see film
• Review medications
• Receive prescriptions and appointment schedule

DAY 5 AFTER SURGERY

• Surgeon
• PA
• Mended Hearts

• Heart monitor
• pacer wires
• Capped IV

• Stop heart monitors
• Remove pacer wires
• Remove capped IV

• Ask for pain medication and sleeping pill
• Ask for laxative if needed

• Healthy Heart Diet

• Morning Discharge (9 a.m.)
• Up in chair
• Walk in hall 3-4 times, 200-400 ft.
• Shower
• IS every hour while awake

• Driver designated and clothes for home at bedside

• Review packet and see film
• Review medications
• Receive prescriptions and appointment schedule