Camilla Armstrong,a 59-Year-Old Woman with Multiple Prior Cardiac Procedures for Congenital

Camilla Armstrong,a 59-year-old woman with multiple prior cardiac procedures for congenital cardiac anomalies at birth,is scheduled for an open approach coronary artery bypass graft.During the preoperative interview and assessment,the perioperative nurse reviewed Camilla's hematologic tests,including a detailed coagulation profile to uncover possible hemorrhagic disorders.During the assessment the nurse learned of Camilla's many varied co-morbid conditions,including prior vascular procedures,fibromyalgia,diabetes,and eczema.The nurse noted one of Camilla's many nursing diagnoses as:Risk for Bleeding related to surgical incision(s) ,tissue dissection,altered coagulation function,and inadvertent hypothermia.As a result of this diagnosis,the nurse implemented measures to have blood available,measure and report blood loss,assist with the use of the autotransfusion system per protocol,and have topical hemostatic agents available.The patient will be free from excessive bleeding as evidenced by (select all that apply) :

A) chest tube drainage less than 100 mL/hr.
B) dressings dry and intact.
C) normal cardiac function studies.
D) normal skin color,temperature,and turgor.