Cardiac catheterization (kath-uh-tur-ih-ZAY-shun) is a procedure used to diagnose and treat cardiovascular conditions. During cardiac catheterization, a long thin tube called a catheter is inserted in an artery or vein in your groin, neck or arm and threaded through your blood vessels to your heart.
Using this catheter, doctors can then do diagnostic tests as part of a cardiac catheterization. Some heart disease treatments, such as coronary angioplasty, also are done using cardiac catheterization.
Usually, you'll be awake during cardiac catheterization, but given medications to help you relax. Recovery time for a cardiac catheterization is quick, and there's a low risk of complications.
2. OBJECTIVE
1. Define Cardiac catherization
2. Enlist indication for cardiac catherization
3. Demonstrate the procedure
4. Discuses complication
5. Discuses pre &postoperative nursing diagnosis
6. Enlist nursing intervention
3. CARDIAC CATHERIZATION
Def: it is an invasive procedure used to identify cardiac anatomy;
measure intracardiac pressure,shunt,and oxygen saturations:and
calculate systemic and pulmonary vascular resistance. (also called
cardiac cath or coronary angiogram)
The procedure is performed in an area of the hospital called the
catheterization laboratory, or “cath lab.”
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6. INDICATION
To confirm or establish the diagnosis.
To measure cardiac output.
To measure pressure and oxygen saturations.
To calculate intra cardiac shunting and pulmonary and systemic
vascular resistance.
To visualize coronary arteries.to assess for myocarditis or
rejection following heart transplantation.
To intervene in congential heart disease
7. PROCEDURE
Catheter insertion site include femoral vein or artery,umbilical
vein or artery ,brachial vein or internal jugular vein.
Under fluoroscopy , Catheter are guided through the heart
collecting pressure measurements and oxygen saturation.
Contrast dye is injected through the Catheter to visualize blood
flow patterns an structural abnormalities.
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10. COMPLICATION
Aysrthymias(usually catheter induce)
Infection.
Bleeding at catheter insertion site,large hematoma
Allergic reaction to contrast material.
Loss of pulse in the extremity used for cannulation.
Perforation of heart or vessels .
Stroke.
Death.
11. NURSING DIAGNOSES
Preoperative
Fear related to surgical procedure.
Deficient knowledge regarding surgical procedure and associated
nursing care .
Postoperative
Risk for injury related to complications of cardiac catheterization.
12. PRE-CATHETERIZATION NURSING
INTERVENTIONS
Reducing fear in child and parents.
provide specific instruction in nonthreatening manner.
Day and time of the procedure
Nothing –by-mouth- (NPO) guidelines.
Sedation versus general anesthesia.
Site of the planned arterial and venous puncture.
13. NURSING INTERVENTION
Provide appropriate teaching geared toward the child,s age and
level of cognitive development.use diagrams models ,as
appropriate.
Give child opportunity to express fears and ask questions.
14. POST-CATHETERIZATION
INTERVENTIONS:
Before the patient returns to the unit, the nurse should ensure that all
equipment is avialble to evaluate and maintain the patient once he arrives.
These are things such as, intravenous pole with plump, blood pressure cuff,
pulse oxmetry, telemetry if ordered, and sand bag.
when the patient returns he may be placed on bed rest with the head of the
bed no higher than 30 degrees. The patients affected extremity must be kept
straight
Insure the patient is fully awake, encourage the patient to drink at least two
liters of fluid during the first 12 hours post cardiac cath. if his condition
warrants and if it is not contraindicated.
15. POST-CATHETERIZATION
INTERVENTIONS
Maintain the patient on hourly intake and output.
If the patient starts to bleed at the puncture site, hold pressure
above the insertion site until the bleeding is stopped. Do not hold
pressure directly on the departure site. Notify the physician.
16. EXPLAINING AND PROVIDING NURSING CARE
obtain baseline set of vital signs: heart rate ,BP respiratory rate, and oxygen saturation.
measure and record child,s height and weight.
note time of oral intake : solids and liquids.
identify known allergies.
list current medication and note time last taken.
help child change into a hospital gown.
start peripheral iv, as needed.
assess and mark the location of pulse (dorsalis peis,posterior tibial.)
17. OBSERVE FOR AND PREVENT
COMPLICATION
Monitor and record routine vital sing ,extremity temperature ,color, and
pulse, check with vital sings.
Notify health care provider for:
Heart rate ,respiratory rate , or BP
Bleeding or increasing hematoma at puncture site.
Changes in oxygen saturations.
Fever.
Cool , pulseless extremity.
18. FAMILY EDUCATION AND HEALTH
MAINTENANCE
Provide discharge information:
Care of incision or puncture site
Activity restriction.
Observe for and report late complications : redness , swelling ,drainage from
puncture site.
Follow up medical care.