Question

Case Study: Cardiac Catheterization

The nurse working in the cardiac procedures area receives a patient who has undergone a cardiac catheterization via the right femoral artery for evaluation of unstable angina. Prior to the procedure, the patient was NPO for 12 hours, and received a sedative. An IV catheter was placed for administration of the contrast agents and for access in case of an emergency situation.

1. What is the rationale for assessing distal pulses immediately after the catheterization?

2. What other assessments should the nurse perform to check for arterial insufficiency?

3. The patient asks why he needs to stay in bed with the leg extended for 2 to 6 hours. How should the nurse respond?

4. After the procedure, why is it important to assess the patient’s BUN, creatinine, and fluid volume status?

Answer 1

A) To assess the neurovascular functioning and any injury to it , the distal pulses are immediately assessed after the procedure so that necessary actions can be taken as early as possible.

B) Assess for bradycardia, dysrhythmias, hypotension, and hypoxemia; assess heart and respiratory rate for 1 full minute; assess pulses for equality and symmetry, assess temperature and color (a cool extremity with skin that blanches may indicate arterial obstruction); assess insertion site (femoral or antecubital area) for bleeding and/or hematoma

C) To prevent bleeding maintain the affected extremity in a straight position for 4-8 hr.

D) After the procedure , it is important to assess te patients BUN , creatinine ,and fluid volume status because a contracst is injected during the procedure . That can cause renal dysfunction if not flushed out . Monitor I&O to assess for adequate urine output, hypovolemia, or dehydration; monitor for hypoglycemia, IV fluids with dextrose; encourage oral intake, starting with clear liquids; encourage the child to void to promote excretion of the contrast medium