Which of the following is an expected postoperative assessment?

• A. Pain
• B. Incisional drainage
• C. Bleeding
• D. Fatigue

Answer: (C)

After CABG, some bleeding is expected because surgery with heparinization and tissue manipulation leaves a normal amount of blood loss that chest tubes are placed to drain. The key postoperative assessment is monitoring chest tube drainage to gauge bleeding and hemodynamic stability. A normal pattern is a measurable drainage that gradually decreases over the first hours; a sudden or large increase in drainage signals potential mediastinal bleeding or tamponade and requires prompt action. While pain and fatigue are common after any major surgery and incisional drainage is also expected, the most critical objective measure in the immediate postoperative period is the amount and trend of bleeding discerned from the chest tube output.