منتديات تمريض مستشفى غزة الاوروبي
عزيزي العضو هذه الرسالة تفيد بانك غير مسجل لدينا ، ونرجو منك التسجيل حتى تتمتع بصلاحيات اكثر وافضل
ونرجو التسجيل باسم عربي يليق بشخصيتك مع العلم انه في حال التسجيل باسم مخالف سوف نقوم بحذف عضويتك
وبريد هوت ميل او ياهو فقط.


...:: منتدى يختص بشئون التمريض عامة والتمريض في مستشفى غزة الاوروبي خاصة ::...
 
الرئيسيةمجلة تمريض مستشفى غزة الاوروبيمجموعتنا ع الـ FaceBookالبوابةاليوميةس .و .جبحـثالتسجيلدخول

شاطر | 
 

 Cardiac Catheterization

اذهب الى الأسفل 
كاتب الموضوعرسالة
ashrafarja
مشرف
مشرف
avatar

عدد المساهمات : 17
نقاط : 25
تاريخ التسجيل : 25/11/2011

مُساهمةموضوع: Cardiac Catheterization   السبت ديسمبر 17, 2011 12:56 pm

Coronary Angiography

Purpose:-

- It is used to evaluate the presence and location of coronary artery disease.

Procedure:-

- A catheter is introduced into the arterial system retrograde to the ascending aorta under fluoroscopy.

- The right or left main coronary artery is then selectively cannulated, and a radiopaque dye is injected directly into the artery through the catheter.

- As dye flows through the artery.

- The lumen of the artery can be visualized and the image recorded on film.

- Disease in the coronary artery or one of its branches delays or obstructs the flow of dye and may be visualized on the film as a site of lumen narrowing and slow filling of the artery with dye.

- In patients who have undergone previous coronary bypass surgery,selective injections of saphenous vein bypass grafts or internal mammary arteries can be performed in a similar manner.

Nursing Care

Role of nurse before cardiac catheterization

- Explain procedure to patient and family.

- Inform the patients about the procedures that will be performed

- Verify that the patient has taken nothing by mouth for at least 6 hours before elective cardiac catheterization except prescribedmedications as advised by the physician.

- Ensure ordered preoperative laboratory studies have been completed and results are available.

- Verify patient allergy information; ***** physician if patient is allergic to radiographic dye, medications, or specific foods.

- Ensure that informed consent has been obtained.

- Start hydration with IV fluids before the procedure and continue
afterward. (Because the dye may be nephrotoxic).

- Establish intravenous access per institutional protocol or physician order.

- Place patient on cardiac monitoring system with blood pressure and pulse oximetry monitoring.

- Provide supplement oxygen as ordered / indicated.

- Pre-medicate patient per physician order.

- Administer a mild sedative for patients before the procedure as prescribed

- Obtain vital signs before transfer to catheterization laboratory.


Health teaching before cardiac catheterization:-


- Instruct the patient not to take anything by mouth for at least 6 hours before the procedure except pre******ion medications as advised by the physician to reduce the chance of nausea and vomiting during the procedure.


- Tell the patient that an intravenous line will be placed to allow fluid and medication administration before, during, and after the procedure.


- Tell the patient that preoperative medication will be given before transport.


- Inform the patient that only a patient gown will be worn during the procedure.


- Advise the patient that the catheterization laboratory is usually cool, and the procedure table is firm and may be uncomfortable after a prolonged time.

- Tell the patient that he may be asked to turn his head, hold his breath, or cough during the procedure.

- Advise the patient that he may experience some discomfort during the procedure but that local anesthesia will be administered to minimize pain.

- Inform the patient that he will be placed on a cardiac monitor for the duration of the procedure and for a few hours after the procedure.

- Tell the patient that he will have to lie flat for several hours after the procedure to minimize the chance of bleeding from the catheter site.

- Inform the patient that he will be encouraged to take oral fluids as tolerated after the procedure to assist in elimination of the radiographic dye.

- Encourage the patient and family to ask questions.





Role of nurse during cardiac catheterization

- Assess patient vital signs, oxygenation, level of consciousness, and cardiac rhythm continuously per institutional protocol.

- ***** attending physician to significant changes in vital signs, oxygenation, and presence of malignant cardiac arrhythmias (e.g., premature ventricular contractions, ventricular tachycardia, ventricular fibrillation).


- Be prepared to initiate cardiac resuscitation with emergency equipment and medications.

Health teaching during cardiac catheterization:-

- Instruct the patient to inform the physician and team if he is experiencing chest pain.
- Remind the patient to lie still.
- Reassure the patient and allay anxiety.
- Encourage and answer the patient’s questions.

Role of nurse after cardiac catheterization

- Ensure patient vital signs are stable before transfer.

- Check catheterization site dressing for bleeding and integrity.

- Check distal pulses below catheterization site; if femoral site was used, check distal pulse, extremity color, capillary refill, and neurosensory status.

- Keep extremity straight and instruct patient not to bend leg or arm.

- Maintain intravenous infusion per physician order or institutional
protocol.

- Maintain supplemental oxygenation support as ordered or indicated.

- Encourage oral fluids as ordered.

- Monitor renal function closely after the procedure for patients with low cardiac output or renal impairment ( they are especially susceptible to dye nephrotoxicity

- Check patient’s coagulation status per institutional protocol before sheath
removal.




Role of nurse when catheter is removed:

- Apply direct pressure over invasive site for 20 to 30 minutes to prevent bleeding or apply commercial hemostatic compression device per institutional protocol.

- Apply pressure over the site when percutaneous access is used, until bleeding has ceased. A pressure dressing, and in some laboratories, a sandbag, is left in place for several hours after the procedure.

- Check distal extremity for pulse, color, capillary refill, and sensorium.

- Remind patient to lie flat for 4 to 6 hours per institutional protocol.

- Place patients on bed rest for 6 hours after the procedure
- Instruct the patient not to flex the affected extremity.
- Check site dressing every 4 to 6 hours for bleeding and integrity.
- Check the access site after the procedurefrequently for signs of :-

- Bleeding,
- Swelling,
- Hematoma formation.

- Monitor peripheral pulses in the affected extremity if a femoral arterial access site was used.

- Monitor blood pressure and heart rate closely and an awareness that retroperitoneal bleeding frequently presents as low back pain are useful in preventing a significant bleed.

- They should be instructed that they will be placed on a table with rounded sides and that their body will be strapped down so that they will not move as the table rotates from side to side.


- If they are to undergo ventriculography, they should be instructed that they may experience a temporary hot flash or flushing when dye is injected into the left ventricle.

- Post- catheterization procedures also should be explained to the patient, including bed rest and monitoring of the access site and vital signs.

- If the patient is to be discharged after the procedure and a cut down was used for access, the patient should be instructed to make a follow-up appointment with the physician for suture removal




Health teaching after cardiac catheterization:-

- Remind the patient to lie still and keep the extremity straight.

- Instruct the patient to verbalize any chest pain or shortness of breath if present.

- Tell the patient when the catheter sheath is due for removal.

- Encourage the patient to take oral fluids as ordered.

- Advise the patient that the physician will review the catheterization findings with him

_________________
الرجوع الى أعلى الصفحة اذهب الى الأسفل
معاينة صفحة البيانات الشخصي للعضو
 
Cardiac Catheterization
الرجوع الى أعلى الصفحة 
صفحة 1 من اصل 1

صلاحيات هذا المنتدى:لاتستطيع الرد على المواضيع في هذا المنتدى
منتديات تمريض مستشفى غزة الاوروبي :: قسم القلب والقسطرة :: قسم القلب-
انتقل الى:  
إحصائية الزوار

.: عدد زوار المنتدى :.

.: زوارنا من البلدان التالية :.

Web Site Hit Counter

المواضيع الأخيرة
» كل يوم صورة لتمريض باطنة رجال
الأحد نوفمبر 03, 2013 11:56 am من طرف محمود سامي منصور

» اسئلة الأمتحانات الخاصة بالمزاولة والتوظيف
الأربعاء فبراير 20, 2013 6:24 pm من طرف Admin

» اجتماع مدير التمريض مع رؤساء الاقسام ومشرفين التمريض (الثلاثاء 15/5/2012)
الخميس مايو 17, 2012 8:20 pm من طرف Admin

» الحكيم: اسماعيل زكي محمد البليشي - رئيس شعبة التدريب الميداني بـ كلية فلسطين للتمريض
الإثنين أبريل 09, 2012 9:41 pm من طرف Admin

» محاضرة ECG Interpretation
الأحد أبريل 08, 2012 8:47 pm من طرف Admin

» اجتماع مدير التمريض مع رؤساء الاقسام ومشرفين التمريض (الاثنين 5/4/2012)
الأحد أبريل 08, 2012 1:21 pm من طرف Admin

» الحكيم: رامي لطفي عبداللطيف النملة - قسم باطنة رجال
الإثنين مارس 19, 2012 10:00 pm من طرف Admin

» الحكيم: جمال احمد سليمان زعرب - قسم جراحة رجال
الجمعة مارس 16, 2012 6:52 pm من طرف Admin

» توصيات لجنة مكافحة العدوى لقسم العناية الخاصة للأطفال الرضع scbu
الجمعة مارس 16, 2012 6:08 pm من طرف Admin

» الحكيم: علاء محمد ابو ريدة - قسم الحضانة
الجمعة مارس 09, 2012 10:11 pm من طرف Admin

» برنامج | Internet Download Manager 6.07 Build 15 + Patch | شرح كامل
الجمعة مارس 09, 2012 8:49 pm من طرف Ahmed ibrahim

» الحكيم: نائل محمد قشطة - قسم جراحة المخ والاعصاب
الأربعاء مارس 07, 2012 7:40 pm من طرف Admin

» الحكيم: عدنان حسين عبدالله عاشور - مشرف تمريض
الإثنين مارس 05, 2012 9:31 pm من طرف ashrafarja

» الحكيم: محمود كمال محمود ابو شرخ - قسم باطنة رجال
الإثنين مارس 05, 2012 9:29 pm من طرف ashrafarja

» الحكيم: يامن محمد صالح الدربي - قسم باطنة رجال
الأربعاء فبراير 22, 2012 6:52 pm من طرف Admin

» الحكيم: وسام احمد يوسف مسمح - قسم باطنة رجال
الخميس فبراير 16, 2012 5:27 pm من طرف Admin

» الحكيم: اسعد محمد سلمان العاصي - قسم باطنة رجال
الجمعة فبراير 10, 2012 8:31 pm من طرف Admin

» مناسبات تمريض مستشفى غزة الاوروبي لـ شهر (2-2012)
الثلاثاء فبراير 07, 2012 9:49 pm من طرف Admin

» الحكيم: عمر كامل عبدالمنعم نصر - مشرف تمريض
الإثنين فبراير 06, 2012 11:18 am من طرف Admin

» الحكيم: طارق سعيد محمد القريناوي - مشرف تمريض
الإثنين فبراير 06, 2012 10:18 am من طرف Admin

نوفمبر 2018
الإثنينالثلاثاءالأربعاءالخميسالجمعةالسبتالأحد
   1234
567891011
12131415161718
19202122232425
2627282930  
اليوميةاليومية
حقوق الطبع والنشر
جميع الحقوق محفوظة لـ منتديات تمريض مستشفى غزة الاوروبي
Powered by Alaa Shaat ® egh-nsg.forumpalestine.com
حقوق الطبع والنشر©2017 - 2011

الساعة الآن في مستشفى غزة الاوروبي

أختر لغة المنتدى من هنا