Therapeutic Management

Question 1

Percutaneous transluminal coronary angioplasty (PTCA)

Answer 1

Invasive nonsurigal
Uses-MI
Complications- arterial dissection or rupture, embolization of plaque fragments, spasm, acute MI

Question 2

PTCA PreOp

Answer 2

NPO after midnight
Allergies to iodine
Site preparation 
Baseline v/s and peripheral pulses
Chest pain may occur during ballon inflation

Question 3

PTCA PostOP

Answer 3

Assess distal pulses 
Bed rest, keep leg straight 6 to 8 hours
Anticoagulants, antiplatelet
IV nitroglycerine to prevent coronary artery vasospasm
Encourage fluids

Question 4

Laser-Assisted angioplasty

Answer 4

Used for clients with small conclusions in the distal superficial femoral, proximal popliteal, and common iliac arteries, and in coronary arteries

Heat from the laser vaporizes the plaque to open the occluded artery

Question 5

Coronary artery stents

Answer 5

Used in conjunction with PTCA

Question 6

Atherectomy

Answer 6

Removes plaque from a coronary artery by the use of cutting chamber on the inserted catheter or a rotating blade that pulverized the plaque

Question 7

Transmyocardial revascularization

Answer 7

Used for clients with widespread atherosclerosis involving vessels that are too small and numerous for replacement or balloon catherization, performed through a small chest incision.

Uses a high power laser

Question 8

Arterial revascularization

Answer 8

Increase arterial blood flow to the affected limb

Question 9

Arterial revascularization (PostOp)

Answer 9

Monitor for hypotension (hypovolemia)
Hypertension (may place stress on graph and clot formation)
Bed rest 24hrs
Affected lim straight, limit movement, avoid bending knee and hip
Warm, redness, and edema are expected outcomes because of increased blood flow
Graph occlusion often occurs within the first 24hrs (sharp increase pain)
Assess peripheral pulses
Maintain NPO, with progression to clear liquids
Strict aseptic technique
Excess bleeding
Mint intro graph area for hardness, tenderness, and warmth