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