cardiac catheterization

Question 1

cardiac cath

Answer 1

-insertion of catheter into the heart
-contrast medium is injected
-RCA, LAD, ventricles (assess muscle function),
collateral circulation
-done under fluroscopy

Question 2

What does the test tell us?

Answer 2

evaluates: -heart valves
-heart function
-blood supply
-abnormalities
-ventricular aneurysms
-cardiac enlargement
-evaluates need or open heart surgery
DOES NOT: tell us structural defects
-always done under aeseptic technique, crash cart in room

Question 3

cardiac cath cont

Answer 3

-insertion in groin or radial artery
-advanced up to heart
radial insertion= less healing and recovery time, better, faster procedure
-groin insertion= if doing procedure (CABG, etc.)
-dye is injected-pt. may become flushed& hot from contrast dye
-will discover abnormalities and occlusions

Question 4

things that can be done

Answer 4

• PCI= per-cutaneous coronary intervention
• angioplasty
• stent placement
• atherectomy
• all can correct problem by opening up the artery
• all require pt to be heparinized (heparin antidote: protamine sulfate)

Question 5

angioplasty

Answer 5

• surgical repair or unblocking of a blood vessel, especially a coronary artery
• plaque is mashed against inner wall
• plaque extraction via high speed drill w. diamond head cutters

Question 6

stent placement

Answer 6

open up blocked peripheral artery

• scaffold placed and enlarged
• plavix

Question 7

atherectomy

Answer 7

• removing atherosclerosis from blood vessels within the body
• cuts and pulverizes plaque

Question 8

closing the hole

Answer 8

use: direct pressure
- suture
- angio-seal

Question 9

complications

Answer 9

rate: 1 in 1000 to 1 in 500
- cardiac arrhythmias
- cardiac tamponade
- anaphylaxis (to dye)
- hematoma
- hypotension
- hemorrhage
- stroke or MI
- kidney damage

Question 10

primary prevention

Answer 10

• whos at risk? -diabetics
• hypertension pts
• positive MI or unstable angina pts
• those with known cardiac hypertrophy or cardiomyopathy
• those with known CAD and chest pain
• anyone presenting the ED with chest pain and EKG changes

Question 11

pre-op

Answer 11

-NPO
-informed consent
-teaching (positioning, allergies: benadryl, mucomist)
-dye (renal failure?)
-cough
-pain/pressure
-pt is usually awake and given versed (causes amnesia, waking sleep)
iodine, shellfish, contrast allergies

Question 12

post-op

Answer 12

• flat in bed for 4-6 hrs, operated leg straight, movement mat cause hole to blow
• hydration- flushes dye out
• VS q15 mins., doppler always on foot to assure pedal pulse
• site & pulse assessment q15 mins, possible bleeding or hematoma
• same day procedure

Question 13

discharge instructions

Answer 13

• pt education: avoid heavy lifting
• avoid vigorous exercise
• small bump/ bruising
• no bending, lifting, twiting
• notify MD if: pain/swelling at insertion site
  - chills/fever (possible infection)
  - pain/color change to extremity (possibl loss of blood flow)

Question 14

nursing diagnoses

Answer 14

• impaired skin integrity
• risk for infection
• fluid volume deficit/ overload
• knowledge deficit
• fear/anxiety
• risk for acute pain