Transcript CARE OF THE CARDIAC CATH PATIENT

CARE OF THE
CARDIAC CATH
PATIENT
Meg Morris, RN, CCRN, Nurse Clinician II
Zir Cardiac Cath Lab
January 20, 2011
PRE CATH PREPARATION :
OR....
WHAT TO DO WHEN THE CATH LAB
CALLS FOR THE PATIENT
 GET THE PATIENT READY !
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HAVE PATIENT VOID
CLEAN JOHNNY
NO PANTS OR UNDERWEAR
CHART WITH MED SHEETS AND GREEN
CARD
PRE CATH MEDS
 ANY QUESTIONS CHECK WITH PHYSICIAN
 ASA AND PLAVIX SHOULD BE GIVEN IF ORDERED
AND NOT CONTRAINDICATED
 LASIX: CHECK WITH PHYSICIAN
 BETABLOCKERS AND ANTIHYPERTENSIVES ARE
OK TO GIVE
 ANTICOAGULANTS: CHECK WITH PHYSICIAN
 INSULIN AND DIABETIC AGENTS: CHECK WITH
PHYSICIAN
LEFT HEART CATH
Medications during the
procedure
 Moderate sedation
 Versed
 Fentanyl
Patients are asleep and comfortable but
able to converse with the staff.
Normal Coronary Anatomy
Closing the puncture site
 Angioseal: A combination of stitches and collagen
plug that sits between the artery and the insertion site.
 Vasoseal: A collagen plug only, no stitches, that sits
between the artery and the insertion site.
 V pad: Coagulant pad held over the insertion site to
promote hemostasis.
 Manual hold
Post-procedure care is the same for all
closure devices.
Post cath care: See orders
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Vital signs and groin checks
Pedal Pulses
IV Fluids
Activity: Bedrest HOB no higher than 30
degrees.
Groin care: What to do if
the groin bleeds
Minor bleeding:
Remove dressing, apply pressure for 510 minutes.
If still bleeding or oozing, call for help:
cath lab (5559) during the day, Interns
or residents at night.
Check distal pulses
MAJOR BLEEDING OR
HEMATOMAS
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STAY WITH THE PATIENT !!
Call for help
Remove dressing and hold pressure
Monitor Heart rate and BP and distal
pulses
 IV access a must
 Do not shut off Integrilin without checking
with the Cardiologist.
Discharge Teaching
 Groin care
 Remove the dressing after 24 hours!
 Keep site covered with a bandaid for one week,
change it every day after showering.
 Showering OK after 24 hours, no tub baths,
swimming, or hot tubs for 1 week.
 Activity: No heavy lifting (>10 lbs) for one week.
 Reasons to call the doctor: Fever, bleeding,
vomiting, chest pain.