After a client has undergone coronary artery bypass graft surgery (CABG), which nursing intervention should be prioritized to minimize the risk of complications?

Postoperative care following coronary artery bypass graft (CABG) surgery focuses on early detection of complications such as bleeding, hemodynamic instability, respiratory compromise, and infection. Clients are at high risk for cardiac and systemic complications due to the invasiveness of the procedure and use of cardiopulmonary bypass. Continuous monitoring of vital signs and surgical sites is essential for identifying deterioration early and guiding timely intervention. Prioritizing assessment ensures patient stability before advancing to activity or other interventions. Rationale: A. Encouraging the client to eat a full meal shortly after surgery is not a priority immediately after CABG. Postoperative clients are often at risk for nausea, decreased gastrointestinal motility, and aspiration, especially after anesthesia. Oral intake is usually introduced gradually, starting with clear liquids once bowel sounds and swallowing reflexes are confirmed. Premature feeding may increase complications such as aspiration or vomiting. B. Assessing the client's vital signs regularly and monitoring for signs of surgical site infection is the priority intervention. Post-CABG clients are at risk for bleeding, arrhythmias, hypotension, and decreased cardiac output, all of which can be detected early through frequent vital sign monitoring. Monitoring the incision site also helps identify early infection or impaired wound healing, which is critical in preventing sepsis or mediastinitis. C. Encouraging the client to ambulate immediately after surgery is inappropriate because early ambulation must be gradual and based on hemodynamic stability. Immediate activity can increase myocardial oxygen demand and strain the surgical repair. Ambulation is typically initiated after stabilization, with close monitoring for tolerance such as heart rate, blood pressure, and oxygen saturation changes. D. Administering pain medication on a fixed schedule regardless of the client's reported pain level is not the safest approach. While adequate pain control is essential to promote breathing exercises and mobility, analgesics should be titrated based on assessment to avoid over-sedation or respiratory depression. Overmedication may mask complications such as chest pain related to cardiac ischemia or graft issues.