Cardiac Catheterization

Cardiac Catheterization

: introduction of a catheter into the heart via a peripheral blood vessel to measure oxygen concentration, saturation, and tension in the various chambers of the heart.

: a highly invasive procedure not performed routinely except in cases wherein the patient is experiencing limiting or escalating symptoms of cardiac dysfunction or myocardial ischemia

: used only when objective measures (such as stress test or echocardiography) suggest that the patient has a high risk of progressing deterioration, myocardial infarction, or other adverse events.

B. Purposes of the Procedure

1. Used to accurately characterize the extent and severity of coronary artery disease
and thereby help in deciding the most appropriate plan for medical, surgical, or
catheter-based treatment.

2. Utilized to assess oxygen levels, pulmonary blood flow, cardiac output, heart
structures, and coronary artery visualization

C. Preparation of the Patient

1. Obtain an informed consent; the client should be aware of the procedure’s purpose, its possible complications, and the sensations it causes (e.g. urge to cough, nausea,heat)

2. Provide psychosocial support.

3. Determine the presence of allergies, particularly to iodine / seafoods.

4. Obtain baseline vital signs.

5. Keep the patient on nothing per orem for 6-8 hours before the procedure.

6. Have client void.

7. Administer sedatives as ordered prior to the procedure.

8. Mark distal pulses.

9. Do cardiac monitoring.

10. Inform client that he may experience warm or flushing sensation as the contrast medium is injected. “Fluttering” sensation is felt, as the catheter enters the chambers of the heart.

Heart Catheterization Laboratory

D. Procedure

1. Percutaneous femoral approach: small diameter (2-3mm), hollow plastic tubes or catheters are inserted into the femoral artery (for left heart catheterization) and the femoral vein (for right heart catheterization).

2. Done under local anesthesia.

3. The catheter is advanced under fluoroscopic into the central aorta, where pressure is measured and recorded.

4. Next, the catheter is advanced in retrograde fashion across the aortic valve into the left ventricle, where pressure is measured.

E. Nursing Interventions Post-Catheterization

1. Maintain bed rest for the prescribed number of hours.

2. Monitor vital signs, especially peripheral pulses distal to the insertion site.

3. Monitor electrocardiogram, note for dysrhythmias.

4. To prevent bleeding, apply pressure dressing and a small sand bag or ice over the puncture site.

5. Immobilize affected extremity in extension.

6. Do not place the client’s bed in Fowler’s position if the femoral artery approach was used.

7. Monitor extremities for color, temperature and tingling.

8. Observe for nausea, vomiting, flushing and rash (signs and symptoms of hypersensitivity reaction to contrast media).

Cardiac Catheterization Findings




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