Courtney Unger

March 4, 2021

Mrs. Calcagni

Cardiac Catheterization/ PCI Lab

Cardiac Catheterization, or coronary angiography, is a diagnostic tool used for many

reasons. This procedure is used to determine the presence and extent of coronary artery

disease, assess left and right ventricular function, measure intracardiac pressures, and to

evaluate valvular or other cardiac disorders. This procedure involves 1-2 Nurses, and

cardiovascular technician, a nurse anesthetist or anesthesiologist, and a cardiologist. This

procedure involves going into the artery to determine if there is a blockage or lesion within the

arteries. After conscious sedation and local anesthesia, a vascular sheath is placed in the artery

to allow for guidance for when the stent is inserted. If a narrowed vessel is discovered, a

balloon valvuolplasty may be done to open that passage. After it’s opened, a stent is then

placed to keep the vessel open and patent.

Before the procedure, it is important for the Nurse to review patient medications and

allergies. The dye used in the procedure is iodine based so allergies to iodine or seafood is

crucial to determine. The use of aspirin or other NSAIDS is contraindicated prior to the

procedure due to the increased risk of bleeding. It’s also contraindicated to use sildenafil

(Viagra) prior due to the profound hypotension when taken with nitrates. Metformin should

also be omitted on the day of the procedure as well as 48 hours afterward because it interacts

with the contrast dye and increases the possibility of lactic acidosis. While in the Cath lab, the

nurse’s responsibilities are to prepare the insertion site, monitor the patient’s vitals, cardiac
rhythm and hemodynamics throughout the procedure, as well as give the medications as

ordered. The nurses could also assist the doctor with getting necessary supplies (different

stents, etc.) throughout the procedure. While one nurse was scrubbed in, another nurse was in

charge of charting the procedure which included the supplies that were used, the route or

methods the cardiologist used, and the type and amount of medications that were used

throughout. Post-procedure responsibilities of the RN include, monitoring the patient for any

complications that can occur (peripheral artery thrombosis or embolus, embolic stroke,

contrast allergy, acute renal failure, or acute MI), and patient education which could include

compressing the insertion site when the patient coughs as well as keeping the procedural leg

straight (if down through the femoral artery).

Overall, I think this experience was interesting to see. I enjoyed getting to see the

procedure and structure of the heart. I thought it was interesting to be able to see the

decreased blood flow in the patient’s vessels and how opening them up and putting the stent in

could improve the circulation of blood. Being able to see this procedure after discussing it in

class was also very beneficial. It allowed me to see the whole picture, as to how they patients

are treated and what interventions are done in order to improve the patient’s overall health. I

also enjoyed seeing how the healthcare team worked together throughout the procedure.

Everyone was very nice and encouraging throughout my clinical day. They were open to

teaching and answering any questions I had throughout. I would recommend this experience to

other students, especially if they are interested in learning more about the cardiac system and

interventions done to improve function.