4 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 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.

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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:

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

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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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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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