A patient is recovering from coronary artery bypass graft (CABG) surgery. Which nursing intervention is crucial during the early postoperative phase?

Choice A rationale Minimizing ambulation is actually detrimental to a patient recovering from a coronary artery bypass graft. Early mobilization, typically starting within 24 hours of surgery, is encouraged to prevent deep vein thrombosis, pulmonary embolism, and atelectasis. Immobility leads to venous stasis and decreased muscle tone, which can prolong the recovery phase and increase the risk of hospital-acquired complications. Encouraging movement helps maintain circulation and improves the overall functional capacity of the patient during the healing process. Choice B rationale After CABG, patients are at high risk for pulmonary complications like atelectasis and pneumonia due to the effects of anesthesia and the pain from a sternotomy. Deep breathing and coughing exercises, often using an incentive spirometer, are crucial to re-expand the lungs and clear secretions. This intervention improves oxygenation and prevents the collapse of small airways. Splinting the chest with a pillow during these exercises helps manage pain while ensuring the patient can perform effective respiratory maneuvers. Choice C rationale Allowing a patient to sleep continuously without interruptions is not feasible or safe during the early postoperative phase of CABG. Frequent nursing assessments, including vital signs, chest tube drainage monitoring, and neurological checks, are required every 1 to 2 hours. Constant monitoring is necessary to detect early signs of cardiac tamponade, hemorrhage, or low cardiac output syndrome. While rest is important for healing, the medical necessity of close observation outweighs the benefit of uninterrupted sleep in this critical period. Choice D rationale Keeping a patient strictly NPO for 48 hours is usually unnecessary after CABG unless there are specific complications like a prolonged ileus or a failed swallow study. Most patients are transitioned from clear liquids to a heart-healthy diet as soon as they are extubated and demonstrate bowel sounds. Prolonged fasting can lead to a catabolic state, which delays wound healing and reduces the energy levels needed for physical therapy and early ambulation. Proper nutrition is vital.