Cardiac Cath NUR 422

Definition of Cardiac Catherization Comprehensive term to describe minor surgical procedure for diagnostic evaluation or interventional (therapeutic) purposes Diagnostic Collects data to evaluate PT’s condition Therapeutic To intervene by mechanical means to treat disorders of the vascular and conduction systems within the heart

Indications Suspected or known coronary heart disease Myodcardial infarction Sudden cardiovascular death Valvular heart disease Congenital heart disease Aortic dissection Cardiomyopathy Initial and follow up assessment for heart transplant

Contraindications PT refusal Uncontrolled hypertension Active GI bleed Bleeding disorders Pulmonary edema Uncontrolled ventricular arrhythmias Aortic valve endocarditiis Allergic to contrast Active GI bleed Renal failure Recent stroke Fever from infection Electrolyte imbalance Anemia Short life expectancy Digitalis intoxication

Complications and Risks Death Myocardial infarction CVA Arrhythmia Hemorrhage Contrast Hemodynamic Perforation

Pre-Catheterization Care IV started Sedation and nausea Nothing to eat 4-6 hours before procedure Records of procedure PT hemodynamic data Medications administered Supplies used Other pertinent information

Catheter Introduction Prepare catheter introduction site with aseptic technique Shaved and cleaned Can be at femoral (most common), brachial, radial, axillary, jugular and subclavian areas

Data Collection Physiologic data unusually collected Hemodynamic parameters Includes blood pressure Cardiac output Vascular pressures (inside & outside the heart) ECG Oximetry readings Blood samples to measure oxygen saturations levels in various parts of the heart

Coronary Angiography LT coronary artery Normal LT coronary Artery

PTCA with Stenting

PTCA with Stent Placement

Post Catheterization Care Firm pressure is applied to puncture site for 15-30 minutes Wound sites are cleaned and dressed The patient will be observed in recovery for 4-8 hours The insertion site will be checked frequently for signs of bleeding. Medications and discharge instructions are given Lots of fluid should be taken in Vital signs should be monitored for 24 hours