4 Cardiac Catheterization Nursing Care Plans

June 20, 2018

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 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 includes 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) for cardiac catheterization:

Ineffective Peripheral Tissue Perfusion

Ineffective Tissue Perfusion: Decreased in the oxygen resulting in the failure to nourish the tissues at the capillary level.

May be related to

Clot formation at the puncture site

Possibly evidenced by

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

Desired Outcomes

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

Nursing Interventions	Rationale
Assess affected extremity, noting its color, temperature, and capillary refill; Palpate distal pulses; Use doppler every 15 minutes for 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 for prompt intervention as needed.
Encourage bed rest and keep affected extremity straight or slight bend in the knee (10 degrees) for 6 hours.	Bed rest and slight, or no flexion, provides improve circulation and minimizes the risk of further trauma which could promote the formation of a clot.
Provide warmth to the opposite extremity.	Enhances blood flow without causing risk of increased bleeding at the site.
Inform parents and child of a need for frequent vital signs monitoring and importance of bed rest with an extension of the extremity.	Promotes understanding and cooperation.