Pediatric Nursing Demystified

Treatment

Balloon angioplasty

Resection of the coarcted portion with end-to-end anastomosis of the

aorta

Enlargement of the constricted section by a graft prosthetic

Nursing Interventions for Child Undergoing Cardiac

Catheterization

Prepare the patient for cardiac catheterization:

• Take complete nursing history.


• Patient must be NPO for 4 to 6 hours.


• Complete assessment including calculation of body surface area.


• Check for allergies; allergies to iodine, contrast dyes, and shellfish
  should be relayed to the physician prior to the procedure.


• Document baseline assessment of pedal pulses and pulse oximetry.


• Utilize child life specialists to alleviate anxiety for the child and family.


• Arrange a tour of the lab with the child if age appropriate.


• Explain specific aspects of the procedure such as the placement of
  the IV and ECG electrodes.


• Demonstrate how the skin will be washed with brown soap and how
  the skin will be numbed.


• Explain how the contrast affects the patient and how sedation will
  make the child feel.
  Care of the patient after cardiac catheterization:


• Monitor patient with cardiac monitor and pulse oximeter prior to
  discharge.


• Monitor the patient for
  Temperature and color distal to the catheter insertion site
  A pulse of the extremity distal to the catheter insertion site


• Take vital signs every 15 minutes for the first hour and hourly
  thereafter.


• Monitor for trends and assess for possible hypotension, tachycardia,
  and bradycardia.


• Check the pressure dressing for evidence of bleeding.


• Observe for bleeding at the insertion site or evidence of hematoma.


• Monitor intake and output for diuresis from contrast material.


• The patient and family should be provided with education upon
  discharge to
  Observe the site for signs of inflammation and infection
  Monitor for fever
  Avoid strenuous activities for a few days
  Avoid tub baths for 48 to 72 hours
  Use acetaminophen or ibuprofen for discomfort

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CHAPTER 6/ Cardiovascular Conditions^109