1
Q
Cardiac Catheterization
A
- insertion of catheter into the heart
- contrast medium is injected
- RCA, LAD, Ventricles - assess muscle fx
- Done under fluoro
- insertion in groin or radial artery
- advanced up to the heart
- incision in groin
- dye injected
- will discover abnormalities and occlusions
2
Q
What does the Card. Cath Test tell us?
A
Evaluates:
- heart valves
- heart fx
- blood supply
- abnormalities
- ventricular aneurysms
- cardiac enlargement
- evaluates need for open heart sx
3
Q
So what can be done?
A
- PCI
- Angioplasty
- Stent Placement
- Atherectomy
- all can correct the problem by opening up the artery
- all require the patient to be heparinized
4
Q
Angioplasty
A
-plaque is mashed against inner wall
5
Q
Stent Placement
A
-scaffold placed and enlarged
6
Q
Atherectomy
A
-cuts and pulverizes
7
Q
Closing the hole
A
- direct pressure
- suture
- angio-seal
8
Q
Complications
A
- complication rate (1 in 1,000 to 1 in 500)
- arrhythmias
- cardiac tamponade
- anaphylaxis
- hematoma
- hypotension
- hemorrhage
- stroke or MI
- kidney damage
9
Q
Who’s at risk?
A
Anyone presenting to ED with chest pain & EKG changes
Those with known CAD and chest pain
Those with known cardiac hypertrophy or cardiomyopathy
Those with positive MI or unstable
angina
Diabetics
Hypertension
10
Q
Pre-operative
A
- NPO
- Informed consent
- Teaching (positioning, allergies)
- Dye
- Cough
- Pain/Pressure
- Sedation
11
Q
Post-operative
A
- flat in bed
- hydration (flushes dye)
- VS q15 minutes
- Site and Pulse assessment q15m (possible bleeding or hematoma)
- same day procedure
12
Q
Discharge instructions
A
Patient Education:
- avoid heavy lifting
- avoid vigorous exercise
- small bump/bruising
- notify MD: pain/swelling at insertion site, chills/fever, pain/color change to extremity
13
Q
Nursing Diagnoses
A
Impaired skin integrity
Risk for infection
Fluid volume deficit / overload
Knowledge deficit
Fear / Anxiety
Risk for acute pain
MS2 Exam 1
flashcards
Decks in class (13)
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