The patient is 72 hours postoperative for a coronary artery bypass graft (CABG).The patient's vital signs include temperature 103° F,heart rate 112,respiratory rate 22,blood pressure 134/78 mm Hg,and O₂ saturation 94% on 3L nasal cannula.The nurse suspects that the patient has developed what problem?

Question

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Postoperative fever is fairly common after cardiopulmonary bypass.However,persistent temperature elevation to greater than 101° F (38.3° C)must be investigated.Sternal wound infections and infective endocarditis are the most devastating infectious complications,but leg wound infections,pneumonia,and urinary tract infections also can occur.A potentially lethal complication,cardiac tamponade may occur after surgery if blood accumulates in the mediastinal space,impairing the heart's ability to pump.Signs of tamponade include elevated and equalized filling pressures (eg,central venous pressure,pulmonary artery diastolic pressure,pulmonary artery occlusion pressure),decreased cardiac output,decreased blood pressure,jugular venous distention,pulsus paradoxus,muffled heart sounds,sudden cessation of chest tube drainage,and a widened cardiac silhouette on radiographs.The risk of delirium is increased in cardiac surgery patients,especially elderly patients,and is associated with increased mortality rates and reduced quality of life and cognitive function.Nursing staff can play a critical role in the prevention and recognition of delirium.

The Patient Is 72 Hours Postoperative for a Coronary Artery