A home health nurse is visiting a 72-year-old client who had coronary artery bypass graft surgery 2 weeks ago. The client reports being forgetful and becoming teary easily. How should the nurse respond?

Question

A home health nurse is visiting a 72-year-old client who had coronary artery bypass graft surgery 2 weeks ago.  The client reports being forgetful and becoming teary easily.  How should the nurse respond?

Quizplus · Accepted Answer

Clients who have undergone surgery (eg, coronary artery bypass graft) may experience some postoperative cognitive dysfunction (POCD). This may include memory impairment and problems with concentration, language comprehension, and social integration. Some clients may cry easily or become teary. The risk for POCD increases with advanced age and in clients with preexisting cognitive deficits, longer operative times, intraoperative complications, and postsurgical infections. POCD can occur days to weeks following surgery. Most symptoms typically resolve after complete healing has occurred. In some cases, this condition can become a permanent disorder (Option C). (Option A) The client will most likely feel better in a few weeks, but this statement is not therapeutic and does not really provide any useful information. (Option B) This is good information for the nurse to have, but it does not directly relate to the client's issues of forgetfulness and becoming teary often. (Option D) Two weeks postoperative is most likely too early for a diagnosis of depression. Depression can occur after a major illness or surgery, but antidepressants would be considered only for persistent symptoms. Educational objective: The nurse should teach the client that possible memory impairment and problems with concentration, language comprehension, social integration, and emotional lability are common following major surgery. Symptoms typically resolve after 4-6 weeks or when healing is complete. Persistent problems should be reported to the health care provider.

A Home Health Nurse Is Visiting a 72-Year-Old Client Who