Pediatric Nursing Demystified

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.

Nursing Interventions for Child Undergoing Cardiac Surgery

Provide preoperative care of the child undergoing cardiac surgery.

• Make inquiries to parents and caregivers as to any questions they
  may have about the procedure.


• Orient child and family to strange surrounding prior to surgery day.

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(^102) Pediatric Nursing Demystified