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CARE OF THE CARDIAC CATH PATIENT Meg Morris, RN, CCRN, Nurse Clinician II Zir Cardiac Cath Lab January 20, 2011.

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Presentation on theme: "CARE OF THE CARDIAC CATH PATIENT Meg Morris, RN, CCRN, Nurse Clinician II Zir Cardiac Cath Lab January 20, 2011."— Presentation transcript:

1 CARE OF THE CARDIAC CATH PATIENT Meg Morris, RN, CCRN, Nurse Clinician II Zir Cardiac Cath Lab January 20, 2011

2 PRE CATH PREPARATION : OR.... WHAT TO DO WHEN THE CATH LAB CALLS FOR THE PATIENT  GET THE PATIENT READY !  HAVE PATIENT VOID  CLEAN JOHNNY  NO PANTS OR UNDERWEAR  CHART WITH MED SHEETS AND GREEN CARD

3 PRE CATH MEDS  ANY QUESTIONS CHECK WITH PHYSICIAN  ASA AND PLAVIX SHOULD BE GIVEN IF ORDERED AND NOT CONTRAINDICATED  LASIX: CHECK WITH PHYSICIAN  BETABLOCKERS AND ANTIHYPERTENSIVES ARE OK TO GIVE  ANTICOAGULANTS: CHECK WITH PHYSICIAN  INSULIN AND DIABETIC AGENTS: CHECK WITH PHYSICIAN

4 LEFT HEART CATH

5 Medications during the procedure  Moderate sedation  Versed  Fentanyl Patients are asleep and comfortable but able to converse with the staff.

6 Normal Coronary Anatomy

7

8 Closing the puncture site  Angioseal: A combination of stitches and collagen plug that sits between the artery and the insertion site.  Vasoseal: A collagen plug only, no stitches, that sits between the artery and the insertion site.  V pad: Coagulant pad held over the insertion site to promote hemostasis.  Manual hold Post-procedure care is the same for all closure devices.

9 Post cath care: See orders  Vital signs and groin checks  Pedal Pulses  IV Fluids  Activity: Bedrest HOB no higher than 30 degrees.

10 Groin care: What to do if the groin bleeds Minor bleeding: Remove dressing, apply pressure for minutes. If still bleeding or oozing, call for help: cath lab (5559) during the day, Interns or residents at night. Check distal pulses

11 MAJOR BLEEDING OR HEMATOMAS  STAY WITH THE PATIENT !!  Call for help  Remove dressing and hold pressure  Monitor Heart rate and BP and distal pulses  IV access a must  Do not shut off Integrilin without checking with the Cardiologist.

12 Discharge Teaching  Groin care  Remove the dressing after 24 hours!  Keep site covered with a bandaid for one week, change it every day after showering.  Showering OK after 24 hours, no tub baths, swimming, or hot tubs for 1 week.  Activity: No heavy lifting (>10 lbs) for one week.  Reasons to call the doctor: Fever, bleeding, vomiting, chest pain.


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