Cardiac Catheterization Nursing Care Plans

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Cardiac catheterization is an invasive procedure in which a small flexible catheter is inserted through a vein or artery (usually the femoral vein) into the heart for diagnostic and therapeutic purposes. It is usually done with angiography as radiopaque contrast media is injected through the catheter and visualization of the blood flow is seen on fluoroscopic monitors. Catheterization allows the measurement of blood gases and pressures within the heart chambers and great vessels; measurement of cardiac output; and detection of anatomic defects such as septal defects or obstruction to blood flow.

Therapeutic, or interventional, cardiac catheterizations use balloon angioplasty to correct such defects as stenotic valves or vessels, aortic obstruction (particularly re-coarctation of the aorta), and closure of patent ductus arteriosus.

Nursing Care Plans

Nursing care planning goals for a child who will undergo cardiac catheterization include promoting adequate perfusion, alleviating fear and anxiety, providing teaching and information, and preventing injury. Close monitoring of a child post cardiac catheterization is also crucial for the early identification of complications that will minimize mortality and morbidity rates.

Here are four (4) nursing care plans (NCP) and nursing diagnoses for cardiac catheterization:

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  1. Ineffective Peripheral Tissue Perfusion
  2. Hyperthermia
  3. Fear
  4. Risk For Injury
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Ineffective Peripheral Tissue Perfusion

Cardiac catheterization can disrupt blood flow causing temporary blockages or damage to blood vessels, which can lead to decreased blood flow to the limbs and other peripheral tissues.

Nursing Diagnosis

May be related to

  • Clot formation at the puncture site

Possibly evidenced by

  • Decreased or absent pulses distal to the catheterization site
  • Cool, mottled appearance of the affected extremity
  • Tingling sensation on the affected extremity
  • Pain

Desired Outcomes

  • The child’s involved extremities will be pink and warm.
  • The child will respond to sensation in extremities equally bilaterally.
  • The child’s pulses will be present distal to the catheterization site and equal bilaterally.

Nursing Assessment and Rationales

1. Assess the affected extremity, noting its color, temperature, and capillary refill; Palpate distal pulses; Use doppler every 15 minutes 4 times, every 30 minutes for 3 hours, then every 4 hours.
Formation of a clot at the puncture site and the child is at risk of the clots severely obstructing distal blood and resulting in tissue damage. Frequently assessment of the extremity for adequate perfusion enables prompt intervention as needed.

Nursing Interventions and Rationales

1. Encourage bed rest and keep the affected extremity straight or slight bend in the knee (10 degrees) for 6 hours.
Bed rest and slight, or no flexion, provide improved circulation and minimizes the risk of further trauma which could promote the formation of a clot.

2. Provide warmth to the opposite extremity.
Enhances blood flow without causing the risk of increased bleeding at the site.

3. Inform parents and child of the need for frequent vital signs monitoring and the importance of bed rest with an extension of the extremity.
Promotes understanding and cooperation.

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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses as reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of it’s evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions show how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health 
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

See also

Other recommended site resources for this nursing care plan:

Other nursing care plans for cardiovascular system disorders:

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Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
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