Milkshake with a side of CABG

Once upon a time there was a 60 year old man who really liked milkshakes and cigarettes. He liked them so much that every time he smoked a cigarette he drank a milkshake, he smoked a pack a day. He had complaints of unresolved chest pain, jaw pain, left arm pain, shortness of breath at rest, fatigue (especially with exertion). One sunny afternoon, after these symptoms progressed, he came into the ER with a STEMI and had a CABG surgery. After his CABG he was transferred to the SICU where Kelis, his nurse assessed him. First Kelis attached the cardiac monitor, pressure lines, noted existing drips, attached the ventilator and end-tidal carbon dioxide and pulse ox monitor. Peripheral pulses and signs of perfusion were checked as well as the chest tube placement and output (<150ml/hr). Body temperature was recorded and rewarming occurred because the body temperature was less than 96.8F. The nurse began by oxygenating the patient to maintain adequate SpO2. She increased room temperature and used a warming blanket to prevent hypothermia. Pain was managed by splinting the incision and using a PCA pump. Cardiac output was maintained by giving fluids and blood products. An ECG monitor was used to monitor for dysrhythmia. As a result of these actions the patient was free to return home after copious amounts of education were given, “I can teach you, but you have to change.”