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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Cardiology, Cardiovascular Surgery

Your Heart Surgery and Hospital Stay (7242)

Your Heart Surgery and Hospital Stay (7242) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Cardiology, Cardiovascular Surgery

7242


Your Heart Surgery and Hospital Stay

What can I expect the morning of surgery?
When you arrive at UW Hospital, you go to the First Day Surgery Unit (FDS) where a nurse
helps you prepare for surgery. See map below.

Highland Avenue

To go to the First Day Surgery Unit, enter at the hospital entrance. Follow the gray path to the
D elevator. Take the D elevator to the 3rd floor and turn left to the First Day Surgery Unit
entrance.

Your family members and friends are given a pager and directed to a waiting area. One family
member or friend may stay with you. There is a waiting room at FDS. Family members can
change while you are waiting to go into the operating room. A nurse asks you questions about
your health and helps you get ready for surgery. An anesthesiologist meets with you and
answers your questions. An intravenous catheter (IV) is placed in a vein of your hand or arm.
An IV is used to give you fluids and medicines. You may be given medicine to help you relax.

When you are taken to the operating room (OR), your family and friends are directed to the
Surgical Waiting Area on the 2nd floor. They will check in with the staff at the Surgical Waiting
Area desk. They will have an option of receiving a pager (works anywhere in the building) or
leaving a cell phone number. They will be given updates from the OR using the pager or cell
phone number. If this waiting area is closed or full, they may use the D4/5 waiting area. To get
to the D4/5 waiting area, take the D elevators to the 5th floor. Take a right off the elevators and
go through the double doors. It will be the first room on your right.

Sometime during the day, your family or friends may wish to take your parking pass to the main
information desk to have it stamped and get one pass to be used during your stay.

What can I expect in the OR?
Once you are in the OR, you meet your nurse. He or she will answer any questions you have,
make sure you are comfortable, and explain what is happening. The operating room is often
cold, so please let the nurse know if you would like an extra blanket. Electrocardiogram (ECG)
patches are placed on your chest, a blood pressure cuff is put on your arm, and a plastic clip is
placed on your finger to check your heartbeat and oxygen levels. The anesthesiologist asks you
to breathe oxygen through a soft plastic mask and medicines are given through your IV.

After you are asleep, a breathing tube (ET tube) is placed in your windpipe to breathe for you.
Other lines and monitors are added after you are asleep.

What can I expect when I wake up from surgery?
After surgery, you are taken to the Cardiothoracic Surgery Unit on B4/5. This nursing unit is an
acuity adaptable unit. This means that every room can be an intensive care, intermediate care, or
general care room. So, you may stay in one room for all stages of care. This includes ICU care
to discharge. Your care and equipment will change in your room to meet your needs.

When you first arrive on the unit, you have a breathing tube, IV lines, drains, and monitors. You
can expect to wake up soon after getting to the unit. Though you will likely feel drowsy, you
may hear beeps, alarms, bubbling noises, and voices. This is normal.

Many patients who have had heart surgery tell us that they recall little of the first hours after
surgery. This is normal. When you first wake up, the breathing tube may startle you and make
you feel anxious. The nurses will help you relax and be more comfortable while the tube is in
place. The important thing is to let the breathing machine (ventilator) work for you. It will give
you puffs of air until you are able to breathe on your own. Since it is in your mouth and
windpipe, you are not able to talk; but you can nod, squeeze your hand, or write on a notepad.
Nurses are nearby to help you.

Once you are awake enough to breathe well on your own, the breathing tube is removed. Most
patients have the breathing tube removed 4-8 hours after surgery. When it is removed, you may
talk and begin taking ice chips and fluids. Your throat may be sore and your voice hoarse for a
while.

When the breathing tube is out, nurses ask you to breathe deeply, cough, and use a breathing tool
(incentive spirometer). Good breathing helps you to get rid of the anesthesia and prevent
pneumonia.

To cough and deep breathe
1. Place a pillow over your chest to reduce the pain and support your
chest while coughing.
2. Breathe in deeply and slowly through your nose. Hold it for 2
seconds.
3. Exhale slowly through the mouth.
4. Repeat twice more.
5. Breathe in again; hold it, and then cough.


To use the incentive spirometer
1. Exhale and place your lips tightly around the mouthpiece.
2. Take a deep breath in. Slowly raise the Flow Rate Guide between the arrows.
3. Hold the deep breath. Continue to inhale, keeping the guide as high as you can for as long
as you can, or as directed by your nurse or respiratory therapist.
4. Exhale and relax.
5. Repeat 10 times each hour while you are awake.

Your family and friends may visit once you are settled in your room and have had some time to
recover. It may take 1-2 hours for you to recover. A staff member will tell your family and
friends when visiting is allowed. Visitors are asked to enter the nursing unit from the D
elevators.

What can I expect during my recovery in the hospital?
As you become more stable, many of the IV lines and monitors are removed. As your condition
improves, the nurses will watch you closely but they will not be at your bedside as often. This is
a sign that you are doing well. You can expect to stay in the hospital 4-5 days.

All patients have their blood sugars checked during their hospital stay. If you have diabetes, you
can expect to receive insulin through your IV. You may receive insulin for a few days while you
recover. Some patients who have not needed insulin in the past will be given insulin if their
blood sugars are high. High blood sugars are often due to the stress of surgery.

Rest is important for good healing. At the same time, getting up and walking helps to speed
recovery. Most likely, the day after surgery, we will expect you to walk 4 times a day and be up
in the chair for all meals. You may be surprised how much better you feel each day.

As soon as you are able, you will be walking in the halls and meeting with someone from
physical therapy (PT) for strength training, building stamina, teaching about sternal precautions
and planning for assistance after discharge if needed. Occupational therapy will meet with you
to teach you how to do your activities of daily living such as bathing, getting dressed, assess
assistance after discharge if needed and strength exercises. A person from Preventive Cardiology
will meet with you a few days after surgery. This person will teach you about a heart healthy
diet and exercise. He or she will also help you get started in a Cardiac Rehabilitation (Cardiac
Rehab) program. Most patients resume Cardiac Rehab 2-4 weeks after surgery.

How much pain will I have?
Your doctor and nurses will work with you to achieve good pain control. Good pain control
helps you to:
1. Feel better.
2. Heal faster.
3. Take deep breaths.
4. Start walking and get stronger faster.
5. Leave the hospital sooner.
6. Have better results and avoid problems.

Drug and non-drug treatments can help prevent and control pain. Don’t worry about getting
“hooked” or “addicted” to pain medicines. Studies show that this is very rare unless you already
have this problem. Please ask if you have questions or concerns.


Many patients tell us they don’t feel as much pain with heart surgery as they have had with
abdominal surgeries. Some patients have more pain in the shoulders and back due to the chest
tubes or their position while in surgery.

For best results:

1. Talk with your doctors and nurses about the choices you have. At first, you’ll receive pain
medicine in your IV. When you are able to take sips of water, you will switch to oral pain
medicine.

2. Ask for pain medicine when pain first begins. Do not wait until your pain is severe. This
limits the effectiveness of the medicine. Pain pills take 20-30 minutes to work.

3. The nurses will ask if the medicine is helping your pain. You will be asked to rate your pain
using this scale.

0-10 Number Pain Scale
______________________________________________________
0 1 2 3 4 5 6 7 8 9 10
No Mild Moderate Severe Worst
Pain Pain
Possible

4. The goal should be a level that allows you to deep breathe, eat, walk, and sleep. The doctors
and nurses need you to rate your pain so they know how well your pain medicine is working.

5. Tell the doctors and nurses about pain that will not go away. Do not worry about being a
“bother.” Pain can sometimes be a sign of problems.

Pain medicine may cause you to become drowsy, dizzy, or lightheaded. Narcotic pain medicine
can cause constipation. Tell your doctors and nurses if you are having any of these problems.

What about eating?
After surgery, you may feel sick to your stomach. This is due to the anesthesia. You will slowly
advance from drinking liquids to eating soft foods. Some people lose their appetite and find that
they have a taste like metal in their mouths. Though you may not feel like eating it is important
to eat healthy to allow your breastbone (sternum) to heal. It is not uncommon for heart surgery
patients to lose 15-30 pounds. While you may wish to diet later, now is not the time.

Let your nurse or doctor know if you have a metal or bitter aftertaste in your mouth or if you do
not want to eat your favorite foods. This aftertaste can happen after surgery and it does not last.

While in the hospital, your nurses will be keeping track of the water and other fluids that you
drink. Extra water in the body causes your heart and lungs to work harder. To prevent this, you
may be taking a water pill (diuretic) to rid the body of excess water. You will be asked to limit
the amount of water and fluids you take in. You will be on a low salt diet. You may have more
changes to your diet (low fat or low cholesterol) based on your heart condition.

How do I care for my incisions?
You may shower after surgery when all of the tubes and lines have been out for 48 hours. Before
this time, you bathe at the bedside. When you shower, you should have the stream of water hit
your back, not your incision. The shower stream may be too powerful and remove scabs too
soon. If water goes over the incision, that is okay.

When washing, avoid rubbing your incision. Use a mild, fragrance-free soap and pat dry. Do
not put ointments, lotions, or powders on your incisions. Do not take hot showers or baths.

Tub baths, hot tubs, and swimming pools are not allowed for 30 days or until all incisions are
fully healed. Any staples or sutures will be removed at your first follow-up visit.

Occupational therapy will discuss with you and your family about possible durable medical
equipment you may need after discharge. It is important for you to use this equipment and
protect your incision to allow proper healing.

































Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 5/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7242