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 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 nursing care plans (NCP) and nursing diagnosis for cardiac catheterization:
Risk For Injury
Nursing Diagnosis
- Risk for Injury
May be related to
- Altered hemostasis and trauma from a percutaneous puncture
Possibly evidenced by
- Decreased level of consciousness
- Increased apical heart rate and decreased blood pressure
- Bleeding from the catheterization site
- Bruising
Desired Outcomes
- Child will not experience bleeding from the puncture site.
- Child’s heart rate and blood pressure will remain within normal limit.
Nursing Interventions | Rationale |
---|---|
Monitor vital signs every 15 minutes for 4, every 30 minutes for 3 hours, then every 4 hours. | Vital sign changes may reveal blood loss and with internal bleeding may be the first indicator of health problem. |
Gather baseline laboratory results from pre-catheterization assessment. | Provides comparative data for post-catheterization assessment. |
Keep pressure dressing on the catheterization site and assess every 30 minutes for bleeding. If bleeding does occur, apply continuous direct pressure 1 inch above the puncture site and immediately report to the physician. | Direct constant pressure on site is needed to avoid bleeding; no bleeding, even oozing, should happen. |
Maintain bed rest for 6 hours post-catheterization as ordered. | Bed rest avoids strain to catheterization site which otherwise might hasten bleeding; an elevation of the head (45-degree) and a slight bend at the knees are acceptable; young children may be held by parents, this is beneficial in lessening agitation. |
Encourage parents and child to engage in quiet activities such as storytelling, music. | Allows for expression and interaction without physical stress; provides a distraction for comfort. |
Inform parents and child of the need for periodic monitoring and for bed rest. | Promotes understanding and cooperation. |
Encourage parents of infants and young children to hold their children as an acceptable option for resting in bed. | Allows parents to be in contact and comfort their child in a more normal manner; this minimizes episodes of agitation, thereby encouraging more rest. |
Instruct parents to observe and notify any sign of bleeding immediately. Educate parents that pressure dressing will be removed after 24 hours and that they should continue to assess the site and report to the physician if any bleeding is noted. | Increases close monitoring of the site. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use. - Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively. - NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales. - Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates. - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing. - Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans. - Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you. - Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023. - All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans for cardiovascular system disorders:
- Angina Pectoris (Coronary Artery Disease) | 4 Care Plans
- Cardiac Arrhythmia (Digitalis Toxicity) | 3 Care Plans
- Cardiac Catheterization | 4 Care Plans
- Cardiogenic Shock | 5 Care Plans
- Congenital Heart Disease | 5 Care Plans
- Heart Failure | 18 Care Plans
- Hypertension | 6 Care Plans
- Hypovolemic Shock | 4 Care Plans
- Myocardial Infarction | 7 Care Plans
- Pacemaker Therapy | 7 Care Plans