What needs to be done to prepare for a cardiac catheterization?
- Teach about the procedure, possible interventions, and post procedure care.
- Answer questions
- Have informed consent signed AFTER cardiologist discusses benefits and risks with patient
- Assess for allergies (especially iodine & fish)
- Assess for medication allergies (including lidocaine)
- Orders may include fasting for 3 to 8 hours before the procedure
- Withhold or decrease dosages of scheduled medications
- Establish a peripheral IV line
- Obtain lab tests (K, BUN, Creatinine), CXR, ECG
- Have patient void
- May wear dentures & glasses
- Administer analgesics, sedatives or tranquilizers as directed
What needs to be known about during the procedure?
- Takes anywhere from 30 minutes to 1 hour
- May receive IV meds for sedation as needed
- May receive heparin for anticoagulation and nitroglycerin to expand coronary vessels
- Procedure takes place in a cool, darkened room
- Will lie on a special table where X-rays can be taken
- Will be attached to equipment for continuous cardiac, blood pressure, and pulse oximetry monitoring
- Will be awake throughout the procedure and may be asked to cough or take a deep breath at times
- Should report unusual symptoms (angina) immediately
- When contrast material injected into the left ventricle, may experience a hot flushing sensation, nausea or chest pain lasting about 10 heart beats
- After the procedure, the catheters are removed and bleeding controlled with direct pressure or with vascular closure device
- will be continuously assessed and monitored in a post-cardiac catheterization recovery area
- Usually discharged within 6 to 8 hours of completion of the procedure
What needs to be known after a cardiac catheterization?
- Assess for chest pain/discomfort, nausea and pain at cath site, lower abdominal or low back pain.
- Provide medications as indicated.
- Review physician's orders including activity restrictions and s/s of complications to include MI, stroke, and insertion-site bleeding or infection
- Maintain patient on bed rest
- Keep the affected extremity immobile
- Observe insertion site for bleeding or hematoma, especially if on anticoagulant therapy
- Mark hematoma with a marker around outer perimeter to aid in assessing for an increase in bleeding
- Maintain head of bed elevation, no higher than 30 degrees
- Monitor peripheral pulses, BP, pulse, color & sensation
- Observe cardiac rhythm
- Encourage fluid intake
- Monitor I&O
- Observe for adverse reactions to dye
How often do you assess a patient after a cardiac cath?
- q15 min X 4
- q30 min X 4
- q 1 hr X 4
- q 2 hrs after