CVD 2 Flashcards
(51 cards)
What is cardiac catheterization used for?
to identify and diagnose arterial blockages
What will happen during cardiac catheterization?
- long thin catheter is inserted into an artery in the groin or wrist and threaded to heart
- dye is injected so that heart structures and patency can be visualized via x-ray
- patient is awake but given medicine to relax
What medications are often given during heart cath?
Versed and Fentanyl
Balloon Angioplasty
-catheter has a small balloon on tip that is inflated at site of blockage
How does the balloon angioplasty restore blood flow?
Balloon flattens or compresses the plaque against the artery wall opening up the vessel
Stent Placement
- stent is replaced around the balloon, once the balloon has inflate, it expands against the vessel wall
- balloon is removed but the stent remains in place
Pre-procedure for Heart Cath Care
- vascular status of extremity used
- Allen’s test
- ensure patient is NPO for at least 8 hrs
- shave area
Allen’s Test
done prior to using the radial artery for angioplasty to assess the arterial blood supply of the hand
Modified Allen’s Test
- locate the radial and ulnar artery of hand to be used
- ask patient to clench fist then occlude arteries
- have patient open hand and relax
- release pressure on ulnar artery while still occluding radial artery
- color should return in about 7 seconds
If it takes longer than 7 seconds for color to return to hand what would that mean?
Allen test is positive and the radial artery should not be used (poor collateral blood flow)
Radial Artery Benefits
- reduced risk of bleeding, vascular complications, and death
- improved patient comfort
Femoral Artery Use
- operator experience
- higher vascular complications
- bedrest is necessary
How often should you assess Heart Cath site for bleeding after procedure?
q 15 minutes for the first hour then per protocol
If a hematoma occurs what should be done?
Notify provider immediately then apply direct pressure
How long should the patient be on continuous cardiac monitoring and have vitals taken?
q 15 mins for first hour then q 30 minutes the next hour
How long should the extremity used be kept straight?
4 hours
How long could the patient be on bedrest?
2-8 hours
Post Cath Procedure care
- assess for bleeding
- educate patient to report bleeding or chest pain immediately
- IV fluids x 2 hrs then increase oral fluids
- assistance will be needed first time OOB
How is the heart catheter inserted?
inserted through a plastic introducer sheath (long hollow tube)
Sheath Care
- sometimes patient returns to unit w/ sheath in place
- bending affected limb is contraindicated
- HOB at least 30 degrees or less
- removed by trained cardiac nurse and patient remain on bedrest for 6 hrs
Patient Education after Heart Cath
- no bending at the waist, heavy lifting, or straining for 24 hrs
- no heavy exercise for 4-6 weeks
- no driving for 24-48 hours
- showers only
- monitor for numbness/tingling
When should the patient call the doctor after Heart Cath?
- bleeding
- swelling
- new bruising
- pain at site
- fever > 101.5
If the radial artery was used you should avoid what?
Sleeping on hand and repetitive movement for 24-48 hours
Risks after having Femoral Heart Cath
- hematoma
- pseudoaneurysm
- loss of pulse distal to insertion site
- acute kidney failure
- allergic reaction
- cardiac tamponade
- chest pain
