Discharge Instructions: After Your Child’s Heart Surgery
Your child just had surgery to treat a heart problem. This surgery needed a cut (incision) down the chest or breastbone (sternum) or between the ribs. This sheet give you general guidelines to care for your child at home after heart surgery. Your child’s doctor and nursing staff can answer questions and give you more information.
Caring for your child’s chest and incision
Don’t lift your child under the arms for at least 4 weeks after surgery. Lifting stretches the chest and can cause pain at the incision site.
Keep the incision clean and dry.
Don’t submerge your child in water for a bath for at least 2 weeks after surgery. It’s OK to clean and wash the incision. Pat it dry.
Check the incision site every day for redness, drainage, swelling, or separation of the skin. Monitor your child for pain. Itching is normal, but call the doctor right away if you notice any of the signs of infection listed below.
Keep your child in loose-fitting clothing to prevent rubbing against the incision.
Don’t allow your child to lift any heavy objects for at least 6 to 8 weeks.
Keep your child from rough play or contact sports for 2 to 3 months. Talk with your child's doctor about this.
If your child is a teenager with a driver’s license, don’t allow him or her to drive for at least 2 weeks.
Other home-care issues
Your child may feel pain while recovering at home. It’s important for your child’s healing to control the pain. Give your child over-the-counter or prescribed pain medicines as directed by your child’s healthcare provider.
Most children return to a normal diet while they are still in the hospital. Infants or newborns recovering from heart surgery may have a harder time with feeding. Give your child breastmilk or formula as directed by your child’s healthcare provider.
Protect your child from infections during healing. You should wash your hands often with soap and water. So should anyone else who takes care of your child. Limit contact with visitors and stay away from crowded public areas. If people in the household are ill, try to limit their contact with your child.
Your child will need to rest 1 to 2 weeks at home before going back to normal physical activity or returning full-time to school. It’s important not to push your child until he or she is ready to return to a normal routine. But getting up and walking several times during the day is good for your child’s recovery.
Your child has just gone through a stressful experience and may be unhappy or moody after heart surgery. It’s important to be patient and support your child during this time.
You’ll need to make an appointment with your child’s cardiologist and surgeon. Your child may need follow-up tests to check how well your child’s heart is working.
When to call the healthcare provider
Call your child's healthcare provider right away if your child has:
Increased pain, redness, draining, swelling, or bleeding at the incision site
Fever (see Fever and children, below)
A seizure caused by the fever
A poor appetite
Drinking less fluid
Prolonged nausea and vomiting
A cough that won’t go away
An irregular heartbeat
You don't think your child is getting better
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit (axillary) temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
March 21, 2017
Bernstein, D. Kliegman: Nelson Textbook of Pediatrics (2011); 19th ed.; pp. 1602-1604
Fetterman, Anne, RN, BSN,Mancini, Mary, MD,Turley, Ray, BSN, MSN