UW MEDICINE | PATIENT EDUCATION

UW MEDICINE PATIENT EDUCATION HEART SURGERY KOREAN 심장수술 귀하의차후관리 환자이름 : 수술명 : 수술받은날 : 집도의 : 차후관리방문일 : 요일과날자 시간 이인쇄물은심장수술을받은이후의차후관리에대하여설명합니다. 이것에는클리닉방문과식이요법과활동과언제심장수술팀에게전화해야하는지에관한정보가포함되어있습니다. 귀하의차후관리방문 워싱턴대학병원심장센터에서의심장수술을받았을경우 대략수술받고 1 주일에서 2 주일이후에담당외과의나심장수술고급진료인 (ACP) 을보십시오. 이차후관리방문은퇴원하기전에예약이잡힐수도있습니다. 예약이나예약일변경은클리닉에 206.598.8060 으로전화하십시오. 클리닉에오시면 : 환자분의실밥이제거될수도있습니다. 복용하고있는약들의약병들을가지고오거나최근의약목록을가지고오십시오. 이인쇄물의 3 페이지에있는 일지 를가지고오십시오. 심장외과팀은수술이후 1 달동안, 또는환자분이주치의를볼때까지어느쪽이먼저이든지환자분이복용하는대부분의약들을모니터할것입니다. 환자분은수술이후 1-2 주일정도되면후속관리을받으러심장센터로오실것입니다. Page 1 of 5 심장수술

담당심장과의사와함께 수술이후집에도착하자마자심장과의사의클리닉에전화하십시오. 환자분은환자분의진료팀이권고한것에따라서 1 달이내아니면더빨리담당심장과의사를만나야할것입니다. 심장수술을받은모든사람은담당심장의를다음과같은이유로만날필요가있습니다 : 수술이후의회복상태확인을위하여 심장과관련된위험성을줄이기위하여 고혈압이나심부전증과같은심장문제를위한지속적인관리 주치의와함께 수술이후한달이내로아니면더일찍보라고권고받은대로주치의 (PCP) 를보는예약을하십시오. 환자분의주치의는환자분이수술이전에갖고있던건강문제와수술받은때부터생겼을수도있는새로운문제를살펴줄것입니다. 심장외과팀에게전화해야할경우 다음과같은증세가있으면심장외과팀에게전화하십시오 : 101 F (38.5 C) 보다더높은열이날때 절개선주위의붉은기나부종이나만지면아픈것이더증가할때 절개선이벌어지거나진물이날때 편히쉬고있는상태에서의심장박동이너무빠르거나느릴경우 : 분당 60 보다적음 분당 100 보다많음 심계항진 ( 부정맥 ) 이나박동이건너뛰는문제가새로생김 협심증과같은수술이전에있었던증세가다시나타남 숨쉬는것에변화가오거나숨쉬기가힘듬 혈압이 140/90 보다높거나 90/60 보다낮음 5 일이내에체중이 3 파운드나그이상증가함 발이나발목이붓는것이더증가함 속이메슥거리거나구토함 약을복용할수가없음 후속관리방문까지기다릴수없는질문이나걱정거리가있음심장외과팀은언제나환자분의증세나걱정되는것에대하여상담할수있게연락이가능합니다. 업무시간과업무외시간에이용할전화번호는 5 페이지를참고십시오. Page 2 of 5 심장수술

일지 체중과체온과안정시의심박수와혈압과절개선의상태를기록하기위해서는다음의차트를이용하십시오. 명심하실것은 : 매일동일한체중기로동일한시간대에몸무게를재십시오. 하루두번혈압과심장박동수를확인하십시오 : 아침에복용하는약들을복용하고 1 시간후에 저녁에복용하는약들을복용하고 1 시간후에 날자체중체온안정시심박수 * 혈압 ** 수술절개선의상태 * 안정시심박수가 60 이하이거나 100 이상이면심장외과팀에게전화하십시오. ** 혈압이 140/90 보다높거나 90/60 보다낮으면심장외과팀에게전화하십시오. Page 3 of 5 심장수술

심장수술이후의식사 일반식을하시는경우 수술이후한달동안 : 되도록이면최대한으로열량을섭취하십시오. 단백질을충분히드십시오. 단백질은상처를낫게하는것을돕습니다. 한달이지나면포화지방산과콜레스테롤과중성지방산의수치가낮은음식을섭취하십시오. 당뇨나고혈당문제가있을경우 담당의가다르게말하지않는한미국의당뇨협회 (ADA) 에서권장하는식이요법으로식사를하십시오. 식전과취침전혈당수치를기록하십시오. 할수있는한혈당수치를정상에가깝게유지하십시오. 이것은수술이후절개선이아무는것과감염의위험성을낮추는것을돕습니다. 특별식을하시는경우 의사의처방대로특별식을따라하십시오. 문의하실것이있으시면담당영양사와상담하십시오. 심장수술이후의자신의건강관리 담배제품을쓰는경우 담배에들어있는니코틴은조직으로의혈액이흐르는것을감소시키고상처가아무는것을어렵게합니다. 담배제품을사용하시면담배피는것을끊거나그외의다른담배제품의사용을중단하기를강력하게장려합니다. 도움이필요하시면주치의와상담하시거나 UWMC 의담당의료팀에속한사람과상담하십시오. 걷기 할수있다면걸을수있는만큼걸으십시오. 매일적어도 4 번걷고매일걷는거리를늘리십시오. 걷기는폐렴을예방하고근육을강화시키고몸이회복되는것을돕고혈당을더좋은수치로유지시키는것을돕습니다. 할수있다면계단을오르내리는것은괜찮습니다. Page 4 of 5 심장수술

절개선관리와샤워하기 수술이후 6 주동안은목욕을하거나자쿠지에들어가거나수영을하거나절개부위를물에불리지마십시오. 적어도하루에한번샤워를하고절개부위를씻으십시오. 손은반드시깨끗이씻고순한비누를사용하십시오. 이렇게하는것이감염증의위험을감소시킬것입니다. 그렇게하라고지시받지않는한로숀이나반창고를절개부위에사용하지마십시오. 조심하시고흉골예방책을따르십시오 절개선이가슴의중앙에있다면 : 수술이후 6 주동안, 10 파운드보다더나가는것을들어올리거나당기거나밀지마십시오. (1 갤론의물은 8 파운드보다조금적게나갑니다.) 수술이후 12 주동안, 가슴뼈에스트레스를주거나비틀리게하는활동을하지마십시오. 이것은자전거를타거나공을때리거나골프를하거나테니스를하거나보울링을하는것과같은활동들이포함됩니다. 옆으로눕거나주무셔도됩니다. 가슴에서펑소리나딸깍하는소리가나는것을느끼면심장외과팀에게전화하십시오. 운전 문의사항? 귀하의질문은중요합니다. 질문이나걱정되는것이있으시면 담당의나의료제공자에게 전화하십시오. 주중에는오전 8 시부터오후 5 시까지전화하십시오 : 심장외과간호사 : 206.598.8060 심장외과클리닉 : 206.598.8017 (Fax: 206.598.4669) 심장외과환자관리코디네이터 : 206.598.3636 업무외의시간과주말과휴일은 206.598.6190 으로전화해서 심장외과당직펠로우를호출해 달라고요청하십시오. 절개선이가슴의중앙에있으면 : 수술이후적어도 4 주동안운전하지마십시오. 언제부터다시운전을할수있는지심장외과팀에게물어보십시오. 성생활 그것을하는것이편안하게느껴질때성생활을다시시작하셔도됩니다. 절개부위을보호하고가슴뼈예방책을따라하십시오. 심장외과팀에게전화할경우 심장외과팀에게전화할필요가있으면 : 주중에는오전 8 시부터오후 5 시까지 206-598-8060 으로심장외과외래진료간호사에게전화하십시오. 업무이후의시간과주말과휴일에는 206-598-6190 으로전화해서심장외과펠로우를호출해달라고요청하십시오. 이페이지의 문의사항 칸에있는다른전화번호를참고하십시오. University of Washington Medical Center Heart Surgery: Follow-up care Korean Published PFES: 06/2005, 05/2011, 11/2014 Clinician Review: 11/2014 Translation by UWMC Interpreter Services Reprints on Health Online: https://healthonline.washington.edu Page 5 of 5 심장수술

UW MEDICINE PATIENT EDUCATION Heart Surgery Your follow-up care Patient: Procedure: Surgery Date: Attending Doctor: Follow-up Visit: DAY and DATE TIME This handout explains follow-up care after having heart surgery. It includes information about clinic visits, diet, activity, and when to call your Cardiac Surgery Team. Your Follow-up Visits With Cardiac Surgery at UWMC Regional Heart Center See your surgeon or cardiac surgery advanced care practitioner (ACP) about 1 to 2 weeks after surgery. This follow-up visit may be scheduled before you leave the hospital. Call the clinic at 206.598.8060 to make or reschedule your appointment. At this visit: Your stitches will likely be removed. Bring your medicines or a list of your current medicines with you. Bring your Daily Record, on page 3 of this handout, with you. The Cardiac Surgery Team will monitor most of your medicines for 1 month after surgery or until you visit your primary care provider, whichever is sooner. With Your Cardiologist Call your cardiologist s office as soon as you get home after surgery. You will come to the Regional Heart Center for a follow-up visit about 1 to 2 weeks after your surgery. Page 1 of 5 Heart Surgery

You will need to see your cardiologist within 1 month, or sooner, depending on what your healthcare team has advised. Every person who has cardiac surgery needs to see their cardiologist for: An after-surgery checkup Cardiac risk reduction Ongoing care for cardiac issues such as high blood pressure or heart failure With Your Primary Care Provider Schedule a visit with your primary care provider (PCP) within 1 month after your surgery, or sooner if advised to do so. Your PCP will check on health issues that you had before your heart surgery and any new issues that may have developed since your surgery. When to Call Your Cardiac Surgery Team Call the Cardiac Surgery Team if you have: Fever higher than 101 F (38.5 C) Increased redness, swelling, or tenderness around your incision An opening in or drainage from your incision Fast or slow resting heart rate: Less than 60 beats per minute Or, more than 100 beats per minute New onset of palpitations (irregular heart beat) or skipped beats Return of symptoms you had before surgery, such as angina Changes in breathing, or a hard time breathing Blood pressure higher than 140/90 or lower than 90/60 Weight gain of 3 pounds or more within 5 days Increased swelling in your feet or ankles Been feeling sick to your stomach or are vomiting Not been able to take your medicines Any questions or concerns that cannot wait until your follow-up visit The Cardiac Surgery Team is always available to talk about your symptoms or concerns. See page 5 for phone numbers to use during and after clinic hours. Page 2 of 5 Heart Surgery

Daily Record Use this chart to record your weight, temperature, resting heart rate, blood pressure, and how your incision looks. Be sure to: Weigh yourself at the same time and with the same scale every day Check your blood pressure and heart rate twice: 1 hour after you take your morning medicines 1 hour after you take your evening medicines Date Weight Temperature Heart Rate at Rest* Blood Pressure** How Your Incision Looks * Call your Cardiac Surgery Team if your resting heart rate is lower than 60 or higher than 100. ** Call your Cardiac Surgery Team if your blood pressure is higher than 140/90 or lower than 90/60. Page 3 of 5 Heart Surgery

Your Diet After Heart Surgery If You Are on a Regular Diet For 1 month after surgery: Eat as many calories as you can. Eat plenty of protein. Protein helps with wound healing. After 1 month, eat a diet that is low in saturated fat, cholesterol, and trans-fatty acid. If You Have Diabetes or High Blood Sugar Eat the diet that is recommended by the American Diabetes Association (ADA), unless your doctor tells you otherwise. Record your blood sugar levels before meals and at bedtime. Keep your blood sugar levels as close to normal as you can. This helps your incision heal and lowers your risk for infection after surgery. If You Are on a Special Diet Follow the special diet that has been prescribed for you. Talk with your dietitian if you have any questions. Self-care After Heart Surgery If You Use Tobacco The nicotine in tobacco reduces blood flow to your tissues and makes it hard for your wound to heal. If you use tobacco, we strongly encourage you to quit smoking or using tobacco of any kind. If you need help, talk with your primary care provider or someone on your healthcare team at UWMC. Walking If you are able, walk as much as possible. Walk at least 4 times every day, and increase the distance of your walks every day. Walking helps prevent pneumonia, strengthens muscles, helps your body heal, and keeps your blood sugar at better levels. It is OK to walk up and down stairs, if you are able. Incision Care and Taking a Shower For 6 weeks after your surgery, do not take a bath, sit in a hot tub, go swimming, or soak your incision. Page 4 of 5 Heart Surgery

Take a shower and clean your incision at least once a day. Be sure your hands are clean and that you use a mild soap. This will reduce your risk of infection. Do not use lotions or bandages on your incision unless you are told to do so. Be Careful and Follow Sternal Precautions If your incision is in the center of your chest: For 6 weeks after your surgery, do not lift, pull, or push anything that weighs more than 10 pounds. (A gallon of water weighs a little more than 8 pounds.) For 12 weeks after surgery, do not do any activities that may stress or twist your sternum. This includes activities such as riding a bike, batting, golfing, tennis, or bowling. You may lie and sleep on your side. Call the Cardiac Surgery Team if you feel popping or clicking in your chest. Questions? Your questions are important. Call your doctor or healthcare provider if you have questions or concerns. Weekdays from 8 a.m. to 5 p.m., call: Cardiac Surgery Nurse: 206.598.8060 Cardiac Surgery Clinic: 206.598.8017 (Fax: 206.598.4669) Cardiac Surgery Patient Care Coordinator: 206.598.3636 After hours and on weekends and holidays, call 206.598.6190 and ask for the Cardiac Surgery Fellow on call to be paged. Driving If your incision is in the center of your chest: Do not drive for at least 4 weeks after your surgery. Ask your Cardiac Surgery Team when you can drive again. Sexual Activity You may resume sexual activity when you feel comfortable doing so. Take care to protect your incision and follow your sternal precautions. Calling Your Cardiac Surgery Team If you need to call your Cardiac Surgery Team: Weekdays from 8 a.m. to 5 p.m., call the Cardiac Surgery Outpatient Nurse at 206.598.8060. After hours and on weekends and holidays, call 206.598.6190 and ask for the Cardiac Surgery Fellow on call to be paged. See other phone numbers in the Questions box on this page. University of Washington Medical Center Published PFES: 06/2005, 05/2011, 11/2014 Clinician Review: 11/2014 Reprints on Health Online: https://healthonline.washington.edu Page 5 of 5 Heart Surgery