Def: it is an invasive procedure used to identify cardiac anatomy: measure intracardiac

pressure,shunt,and oxygen saturations and calculate systemic and pulmonary vascular

resistance. (also called cardiac cath or coronary angiogram)

The procedure is performed in an area of the hospital called the catheterization laboratory, or
"cath lab."

INDICATION

To confirm or establish the diagnosis.

To measure cardiac output.

To measure pressure and oxygen saturations.

To calculate intra cardiac shunting and pulmonary and systemic vascular resistance.

To visualize coronary arteries.to assess for myocarditis or rejection following heart

transplantation.

To intervene in congential heart disease

PROCEDURE

Catheter insertion site include femoral vein or artery,umbilical vein or artery brachial vein or
internal jugular vein. Under fluoroscopy. Catheter are guided thre the heart

collecting pressure measurements and oxygen saturation.

Contrast dye is injected through the Catheter to visualize blood

flow patterns an structural abnormalities.

FLUOROSCOPY

Fluoroscopy may be performed to evaluate specific areas of the body; including the bones,
muscles, and joints, as well as solid organs such as the heart, lung, or kidneys.

COMPLICATION

Aysrthymias (usually catheter induce)

• Infection.
• Bleeding at catheter insertion site, large hematoma

• Allergic reaction to contrast material.

• Loss of pulse in the extremity used for cannulation.

▪ Perforation of heart or vessels.

. Stroke.

▪ Death.

NURSING DIAGNOSES

• Preoperative

Fear related to surgical procedure.

• Deficient knowledge regarding surgical procedure and associated nursing care.

• Postoperative

Risk for injury related to complications of cardiac catheterization.

PRE-CATHETERIZATION NURSING INTERVENTIONS

Reducing fear in child and parents.

▪ provide specific instruction in nonthreatening manner.

Day and time of the procedure

othing-by-mouth- (NPO) guidelines.

▪ Sedation versus general anesthesia.

Site of the planned arterial and venous puncture.

NURSING INTERVENTION

Provide appropriate teaching geared toward the child,s age and level of cognitive
development.use diagrams models ,as appropriate.
Give child opportunity to express fears and ask questions.

POST-CATHETERIZATION INTERVENTIONS:

Before the patient returns to the unit, the nurse should ensure that all equipment is avialble to
evaluate and maintain the patient once he arrives. These are things such as, intravenous pole
with plump, blood pressure cuff. pulse oxmetry, telemetry if ordered, and sand bag.

when the patient returns he may be placed on bed rest with the head of the bed no higher than
30 degrees. The patients affected extremity must be kept straight

• Insure the patient is fully awake, encourage the patient to drink at least two liters of fluid during
the first 12 hours post cardiac cath, if his condition warrants and if it is not contraindicated.

POST-CATHETERIZATION INTERVENTIONS

Maintain the patient on hourly intake and output.

If the patient starts to bleed at the puncture site, hold pressure above the insertion site until the
bleeding is stopped. Do not hold pressure directly on the departure site. Notify the physician.

EXPLAINING AND PROVIDING NURSING CARE

obtain baseline set of vital signs: heart rate ,BP respiratory rate, and oxygen saturation.

• measure and record childs height and weight note time of oral intake: solids and liquids

identify known allergies

list current medication and note

last taken.

help child change into a hospital gown.

start peripheral iv, as needed.

assess and mark the location of pulse (dorsalis peisposterior tibial)

OBSERVE FOR AND PREVENT COMPLICATION

Monitor and record routine vital sing extremity temperature color, and

pulse, check with vital sings. - Notify health care provider for

•Heart rate respiratory rate, or BP

Bleeding or increasing hematoma at puncture site.

Changes in oxygen saturations

Fever.

-Cool, pulseless extremity

FAMILY EDUCATION AND HEALTH MAINTENANCE

Provide discharge information:

• Care of incision or puncture site

Activity restriction.

- Observe for and report late complications: redness, swelling .drainage from puncture site.

Follow up medical care.

Reference

• Lippincott manual of nursing practice (2010 edition) Collected data from online source website
Web Med.