C-60 Post Coronary Angiography (Cardiac Catheterization) Care Page 1 of 5Written: March 2005 Nursing Policy C-60Revised: 3/08; 2/11 LSUHSC – Shreveport, LA______________________________________________________________________________ POST CORONARY ANGIOGRAPHY (CARDIAC CATHETERIZATION) CAREPURPOSE:To provide guidelines for the management of patients post cardiac catheterization.DEFINITION:Cardiac catheterization is an invasive procedure involving the insertion of a radiopaque cathetervia the peripheral artery or vein into the heart. Cardiac catheterization is used in the diagnosisand evaluation of congenital, rheumatic, and coronary artery lesions, thrombus in coronaryvessels, and to evaluate systolic and diastolic cardiac function.POLICY:I. The physician shall be responsible for: A. Completing Post Cardiac Catheterization orders.II. The nurse shall be responsible for: A. Implementing all Post Cardiac Catheterization orders. B. Educating patient/family about Post Cardiac Catheterization care.RESPONSIBLEPARTY ACTION RATIONALEMD 1. Completes Post Cardiac Catheterization orders.RN, RN Applicant, 1. Monitor vital signs. TheLPN physician will provide parameters to follow for vital signs.
C-60 Post Coronary Angiography (Cardiac Catheterization) Care Page 2 of 5RN, RN Applicant, 2. Instruct the patient/family toLPN notify the nursing staff immediately for chest pain, shortness of breath, and/or any other changes. If the patient complains of chest pain or shortness of breath notify the physician immediately and obtain vital signs every five minutes. Monitor the patient closely for typical and atypical cardiac symptoms (i.e. left arm pain/numbness, jaw pain, etc.). Contact the START or the Code 99/Blue Team as needed. Document in the medical record.MD, RN, 3. Assesses catheter site for 3. To monitor the patient forRN Applicant, LPN hematoma, bleeding, pain or bleeding and other swelling. The physician complications. should be notified immediately with any changes in the catheter site. For excessive bleeding firm pressure should be applied until the MD arrives. Document in the medical record. 4. Monitors distal pulse, skin 4. To monitor blood flow to color, and warmth of the affected extremity. extremity distal to the catheter site. The physician should be notified immediately of decreased or absent pulses and any changes in skin color/temperature. Document in the medical record.
C-60 Post Coronary Angiography (Cardiac Catheterization) Care Page 3 of 5MD, RN, 5. If a sandbag is used instruct the 5. To prevent bleeding.RN Applicant, LPN patient to leave the sandbag in place. Instruct the patient/family how long the patient is to remain on bedrest, keeping the affected extremity straight. Instruct the patient not to elevate the head of the bed or ambulate until the nurse instructs the patient to do so. Document teaching in the medical record. 6. Instruct the patient and family 6. To prevent infection. to leave the dressing in place for twenty-four hours. If the dressing becomes visibly soiled notify the physician and obtain an order to change the dressing using aseptic technique. Document in the medical record. 7. Assesses the patient for post- procedure pain. Provide pain interventions as needed and document. 8. For patients not on fluid 8. To help the body eliminate restriction encourage increased the contrast dye used during fluid intake for the first 6 to 8 the procedure. hours. 9. Educate the patient/family on 9. To decrease patient/family routine post cardiac anxiety. catheterization care (i.e. vital signs, activity, diet, etc.) and document teaching. 10. Document complications in narrative/progress notes, including physician notification, interventions and outcome of interventions.
C-60 Post Coronary Angiography (Cardiac Catheterization) Care Page 4 of 5MD 11. Provides the patient/family with updates on how the procedure went and when to expect test results.REFERENCES:Cardiac Cath Laboratory Policy 8.3.1: Education of Patient and FamilyDischarge Instructions: Heart Catheterization Lab. Form S/N 6064Infection Control Policy: IC16.0 Methods to Prevent Nosocomial Intravascular Device RelatedInfections.Chulay, M., Burns, S., (2007) AACN Essentials of Progressive Care Nursing. McGraw-Hill Co.Pages 187-188.
C-60 Post Coronary Angiography (Cardiac Catheterization) Care Page 5 of 5Jamie Jett, MBA, RN DateAdministrative Nursing DirectorPsychiatry, Coordinated Care andProfessional PracticeJean DiGrazia, MBA, RN DateAssistant Hospital Administrator and CNOPatient Care Services