Heart Cath Reaction Clinical Tool

NUR 105 - 6/26/2009

HEART CATH LAB REACTION SHEET 1.

LIST 3 (T HRE E) RISK FACTORS

FOR HEART DISE ASE .

HEART DISEASE CAN BE INHERITED OR CAUSED BY A PERSON'S LIFESTYLE. CAUSED RISK FACTORS MAY INCLUDE: SEDENTARY LIFESTYLES, AND OBESITY. OTHER RISK FACTORS INCLUDE: HYPERTENSION, DIABETES MELLITUS, FAMILY HISTORY, MENOPAUSE, GENDER (MALES ARE AT GREATER RISK), AND/OR LEFT VENTRICULAR HYPERTROPHY.

2.

SMOKING,

IND ICATE THE P URP OSE OF A HEART CAT HETER IZATI ON.

HEART CATHETERIZATION CAN BE PERFORMED IN ANY CHAMBER OF THE HEART OR GREAT VESSELS. CATHETERIZATIONS ARE DONE TO DIAGNOSE ABNORMALITIES OR PROBLEMS WITH THE HEART, THEY ARE ALSO USED FOR INTERVENTIONAL TREATMENTS AND EVALUATION OF THE EFFECTS OF PATHOLOGY ON THE HEART AND GREAT VESSELS. DIAGNOSTIC TESTS THAT CAN BE PERFORMED VIA CARDIAC CATHETERIZATION INCLUDE: * MEASURING INTRA-CARDIAL PRESSURE * BIOPSY OF THE ENDOMYOCARDIUM * CARDIAC VALVE EVALUATION * *

3.

ASSESSING THE ANATOMY AND/OR PATENCY OF THE CORONARY ARTERY ESTIMATE THE CARDIAC EJECTION FRACTION AND THE MOTION OF THE HEART WALL

WHAT IS THE NURSE'S ROL E DURING THIS PR OCEDUR E? PRIOR TO THE PROCEDURE THE NURSE IS RESPONSIBLE FOR MAKING SURE THE INFORMED CONSENT IS SIGNED, MAKING SURE THE RIGHT PATIENT AND THE RIGHT PROCEDURE ARE TO BE DONE AT THE RIGHT TIME, AND PREPARATION OF THE PATIENT BOTH

PHYSICALLY AND MENTALLY. MENTAL PREPARATION OF THE PATIENT INCLUDES: ANSWERING ANY QUESTIONS CONCERNING THE PROCEDURE, ENSURING THE PATIENT UNDERSTANDS THE PROCEDURE AND WHY IT IS BEING DONE, WHAT THE PATIENT WILL

EXPERIENCE POST-CATH, DOCUMENTING PATIENT HISTORY, ALLERGIES, CURRENT MEDICATIONS, THE NURSE IS ALSO RELIED UPON TO ADMINISTER A SEDATIVE IF THE PATIENT IS ANXIOUS AND THE PHYSICIAN HAS ORDERED ONE PRIOR TO THE PROCEDURE.

PHYSICAL PREPARATION INCLUDES: TAKING VITAL SIGNS TO BE USED AS A BASE-LINE FOR COMPARISON FOR POST-CATH VITALS,

TEACHING THE PATIENT PAIN MANAGEMENT, HOW TO CARE FOR THE INSERTION SITE, RESTRICTION(S) ON DIET OR/AND ACTIVITY,

PROPER MEDICATION ADMINISTRATION, POST PROCEDURE CARE, AND FOLLOW UP APPOINTMENTS. THE NURSE IS ALSO RESPONSIBLE FOR SHAVING THE GROIN AREA PRIOR TO THE PROCEDURE, STARTING AN IV LINE AND ADMINISTERING FLUIDS IF ORDERED.

DURING THE PROCEDURE THE NURSE MAY BE RESPONSIBLE FOR MONITORING VITAL SIGNS, CARDIAC MONITOR, THE PATIENT'S RESPONSE TO ANESTHESIA, LEVEL OF CONSCIOUSNESS, AND ALSO ASSESSING THE PATIENT FOR ANY SIGNS OF COMPLICATIONS, RELATED TO THE PROCEDURE, ANESTHESIA, OR UNDERLYING CONDITIONS.

FOLLOWING THE PROCEDURE THE NURSE IS REQUIRED TO FREQUENTLY EVALUATE THE PATIENT UNTIL ANESTHESIA HAS WORN OFF AND THE VITAL SIGNS HAVE STABILIZED AND COMPARABLE WITH THE BASE-LINE VITALS TAKEN PRIOR TO THE PROCEDURE. THE

15 MINUTES FOR THE FIRST HOUR OR TWO. THE DRESSING IS ASSESSED FREQUENTLY TO MONITOR FOR ANY SIGNS OF EXCESS BLEEDING OR OTHER COMPLICATIONS. THE NURSE MUST MAINTAIN PRESSURE ON THE INSERTION SITE UNTIL BLEEDING STOPPED AND A CLOT HAS FORMED ON THE SURFACE. ASSESSMENT OF THE PATIENT POST-CATH MAY INCLUDE: NOTING ANY CHANGES IN BEHAVIOR, LEVEL OF CONSCIOUSNESS, PAIN LEVEL, DIMINISHING PULSE(S) DISTAL TO THE INSERTION SITE, THROMBOSIS FORMATION, HEMATOMA FORMATION, EMBOLI, AND ANY OTHER POST-OP COMPLICATIONS THAT MAY OCCUR. THE PATIENT IS TOLD TO REPORT ANY FEELING OF INCREASED TIGHTNESS AT THE DRESSING AS THIS MAY INDICATE A HEMATOMA FORMING. TEACHING THE PATIENT TO AVOID FLEXING THE EXTREMITY OR HYPER EXTENDING IT FOR AT LEAST 12 HOURS BUT UP TO 24 HOURS SO THEY MAY AVOID ANY INJURY. THE PATIENT AND FAMILY/CAREGIVER(S) ARE TAUGHT POSTPROCEDURE CARE, MEDICATION ADMINISTRATION, ACTIVITY RESTRICTIONS AND FOR HOW LONG, DIET RESTRICTIONS (IF ANY), AND THE IMPORTANCE OF GOING TO THE FOLLOW UP APPOINTMENT WITH THEIR PHYSICIAN. AFTER THE NURSE HAS ENSURED THE SAFETY OF THE PATIENT FROM THE BEGINNING TO THE END OF THE PROCEDURE, THEY MUST DISCHARGE THE PATIENT INTO RESPONSIBLE HANDS AS THE PATIENT WILL NOT BE ABLE/ALLOWED TO DRIVE THEMSELVES HOME. SOME FACILITIES REQUIRE THE NURSES EVEN CALL THE PATIENTS 1 - 2 DAYS POST-OP TO ENSURE NO COMPLICATIONS HAVE OCCURRED OR ANY CONCERNS BY THE PATIENT OR FAMILY NEED TO BE ADDRESSED. NURSE USUALLY ASSESSES THE PATIENT EVERY