(kath″ĕt-ĕr-ĭ-zā′shŏn) The use or passage of a catheter.
cardiac c. Percutaneous intravascular insertion of a catheter into the cardiac ventricles, coronary arteries, or great vessels for diagnosis, assessment of abnormalities, interventional treatment, and evaluation of the effects of pathology on the heart and great vessels. Diagnostic tests that can be performed with cardiac catheterization include: 1) assessments of coronary artery anatomy and patency; 2) estimates of cardiac ejection fraction and wall motion; 3) measurements of intracardiac pressures; 4) evaluations of the cardiac valves; and, 5) biopsies of the endomyocardium.
PATIENT CARE: Precatheterization: The nurse prepares the patient physically and emotionally by explaining the procedure and expected sensations. The patient’s vital signs, including the presence and intensity of peripheral pulses, are assessed to establish a baseline measure. Cardiac monitoring leads are applied and an intravenous infusion initiated. Anxiety and activity levels are documented, as well as the presence and pattern of any chest pain. Any known allergies, particularly to shellfish or iodine (suggestive of sensitivity to radiopaque dye), are also documented; the cardiologist is alerted to these allergies or any changes in the patient’s condition. The groin is cleansed and hair is removed locally, and the patient is informed that an oral or intravenous mild sedative (rather than general anesthesia) will probably be given before or during the procedure, so that he or she is able to cough and breathe deeply as instructed during testing. A radiopaque contrast medium is injected into the arteries and nitroglycerin may be administered to aid visualization. After the injection, the patient may feel light-headed, warm, or nauseated for a few moments. The patient will have to lie on his or her back for several hours after the procedure and should report chest pain immediately both during and after the procedure.
During catheterization: Support personnel assist with the procedure according to protocol by monitoring cardiac pressures and cardiac rhythm and the results of hemodynamic studies. The patient’s comfort and safety are assured; changes in emotional status, level of consciousness, and verbal and nonverbal responses are assessed to determine the patient’s response to the procedure and need for reassurance or medication to prevent vasovagal reactions or coronary artery spasm. Any complications, such as cardiac arrhythmias or allergic reaction to the contrast medium, are also evaluated and reported.
Postcatheterization: The nurse provides emotional support to the patient and answers questions. Cardiac rhythm and vital signs (including apical pulse and temperature) are monitored until stable according to protocol (usually every 15 min for the first 1 to 2 hr) or more frequently as the patient’s condition requires. The blood pressure should not be checked in any limb used for catheter insertion. The dressing is inspected frequently for signs of bleeding, and the patient is instructed to report any ...