N310 Cardiac Catheterization Qs&As

N310 Cardiac Catheterization Qs&As Cardiac Catheterization - ANS-Invasive DIAGNOSTIC procedure in which RADIOPAQUE arterial AND venous catheters are introduced into selected vessels to gain access to the RIGHT and LEFT side of the heart & coronary artery circulation. Purposes of Cardiac Cath. - ANS--Evaluate pressures in the 4 chambers of the heart -Measure O2 saturations in the chambers of the heart -Assess coronary artery patency -Assess valve function Right Heart Cath. - ANS--precedes L heart cath -you can get a PCWP -Pulm. artery is the furthest you can go The right side of the heart is accessed by entry of the catheter into a - ANS-vein Access sites for catheters can include the __________ and __________. - ANS-anticubital vein & femoral vein Potential complications of R heart cath: - ANS--cardiac dysrhythmia -vein spasm (treat with nitro) -perforation (will show s/s of cardiac tamponade) -infection Left Ventricular Cath. - ANS-Cath. against blood flow to the left side of the heart The Left side of the heart is assessed by entry of the catheter into a(n): - ANS-artery Access sites for catheters can include the __________, __________, and the __________. - ANS-femoral artery, anticubital artery, and radial artery Potential complications of L heart cath: - ANS--Dysrhythmia -perforation -increased risk for emboli ALWAYS do this test before a radial cath - ANS-Allen's test How to perform an Allen's test: - ANS-1. Tell patient to make a fist 2. Occlude both the radial and ulner pulse 3. Tell patient to open hand 4. Release the ulner Does the patient's hand go from white to pink in 6 seconds or less? -If yes, then it's OK to do a radial cath. -If no, it is NOT SAFE to do a radial cath!!! Advantage to doing a radial cath? - ANS-Patient is up and out of bed quicker 3 ways to seal arterial punctures: - ANS-1. manual pressure (30 minutes) 2. compression devices 3. percutaneous deployed device aka hemostatic plug Pre-Procedural Nursing Assessment - ANS--Assess for known allergic response to contrast media, NOT SHELLFISH (antihistamines and steroids preprocedure is known to be allergic) -Baseline EKG -Lab value assessment -BUN & Creat. (assess for risk factor for radiocontrast media induced toxicity - renal disease, hypovolemia, DM) -PT, INR, PTT, Hemoglobin & Hemat, Platelets, Electrolytes