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CARE OF THE CARDIAC CATH PATIENT Meg Morris, RN, CCRN, Nurse Clinician II Zir Cardiac Cath Lab January 20, 2011. 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
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CARE OF THE CARDIAC CATH PATIENTMeg Morris, RN, CCRN, Nurse Clinician IIZir Cardiac Cath LabJanuary 20, 2011
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
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
Medications during the procedure • Moderate sedation • Versed • Fentanyl Patients are asleep and comfortable but able to converse with the staff.
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.
Post cath care: See orders • Vital signs and groin checks • Pedal Pulses • IV Fluids • Activity: Bedrest HOB no higher than 30 degrees.
Groin care: What to do if the groin bleeds Minor bleeding: Remove dressing, apply pressure for 5-10 minutes. If still bleeding or oozing, call for help: cath lab (5559) during the day, Interns or residents at night. Check distal pulses
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.
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.