exercise are encouraged after the first 24 hours. The patient is encouraged to comb his
hair, reach for objects within normal reach, and then use a pull to raise himself. A pull
may be made from wide gauze attached to the foot of the bed and extending to within
the patient's reach. A T-handle may be inserted or a knot tied in the end of the pull to
facilitate easier grasping. From about the 5th to the 8th day, as determined by the
physician, the patient is allowed to dangle his feet for gradually increasing lengths of
time, then gradually allowed out of bed more and more until the patient is fully mobile,
usually by the 12th to 14th day.
1-34. COMPLICATIONS OF CARDIOVASCULAR SURGERY
As has been stated above, the first 48 postoperative hours are the most critical,
and intensive care should be continued for several days until the patient is out of grave
danger. Respiratory problems, hemorrhage, and shock are problems associated with
any major insult to the body. The following paragraphs discuss complications
associated with insult to the CV system in particular.
Thrombophlebitis is inflammation of a vein with blood clot formation. Venous
stasis (slowing of venous blood circulation) and pressure or other injury to vein walls
predisposes its development. The most common sites for development of
thrombophlebitis are in the veins of the pelvis and legs. A postoperative patient or any
other individual who has remained still for hours at a time with relaxed muscles and a
resultant slowing of venous circulation in the legs is particularly liable to develop
thrombophlebitis. When inactivity is combined with pressure on the popliteal space and
the calf of the leg, the possibility of developing thrombophlebitis increases.
a. Signs and Symptoms of Thrombophlebitis.
Cramping pain in the calf.
Possible redness, warmth, and swelling along the course of the involved
Pain that may appear only on dorsiflexion of the foot.
b. Nursing Implications.
Do not, under any circumstance, rub or massage the affected limb.
Place the patient on immediate bed rest and notify the RN.