1. C-60 Post Coronary Angiography (Cardiac Catheterization) Care Page 1 of 5
Written: March 2005 Nursing Policy C-60
Revised: 3/08; 2/11 LSUHSC – Shreveport, LA
______________________________________________________________________________
POST CORONARY ANGIOGRAPHY (CARDIAC CATHETERIZATION) CARE
PURPOSE:
To provide guidelines for the management of patients post cardiac catheterization.
DEFINITION:
Cardiac catheterization is an invasive procedure involving the insertion of a radiopaque catheter
via the peripheral artery or vein into the heart. Cardiac catheterization is used in the diagnosis
and evaluation of congenital, rheumatic, and coronary artery lesions, thrombus in coronary
vessels, and to evaluate systolic and diastolic cardiac function.
POLICY:
I. The physician shall be responsible for:
A. Completing Post Cardiac Catheterization orders.
II. The nurse shall be responsible for:
A. Implementing all Post Cardiac Catheterization orders.
B. Educating patient/family about Post Cardiac Catheterization care.
RESPONSIBLE
PARTY ACTION RATIONALE
MD 1. Completes Post Cardiac
Catheterization orders.
RN, RN Applicant, 1. Monitor vital signs. The
LPN physician will provide
parameters to follow for vital
signs.
2. C-60 Post Coronary Angiography (Cardiac Catheterization) Care Page 2 of 5
RN, RN Applicant, 2. Instruct the patient/family to
LPN notify the nursing staff
immediately for chest pain,
shortness of breath, and/or any
other changes. If the patient
complains of chest pain or
shortness of breath notify the
physician immediately and
obtain vital signs every five
minutes. Monitor the patient
closely for typical and
atypical cardiac symptoms
(i.e. left arm pain/numbness,
jaw pain, etc.). Contact the
START or the Code 99/Blue
Team as needed. Document
in the medical record.
MD, RN, 3. Assesses catheter site for 3. To monitor the patient for
RN Applicant, LPN hematoma, bleeding, pain or bleeding and other
swelling. The physician complications.
should be notified
immediately with any changes
in the catheter site. For
excessive bleeding firm
pressure should be applied
until the MD arrives.
Document in the medical
record.
4. Monitors distal pulse, skin 4. To monitor blood flow to
color, and warmth of the affected extremity.
extremity distal to the catheter
site. The physician should be
notified immediately of
decreased or absent pulses
and any changes in skin
color/temperature.
Document in the medical
record.
3. C-60 Post Coronary Angiography (Cardiac Catheterization) Care Page 3 of 5
MD, RN, 5. If a sandbag is used instruct the 5. To prevent bleeding.
RN Applicant, LPN patient to leave the sandbag in
place. Instruct the
patient/family how long the
patient is to remain on bedrest,
keeping the affected extremity
straight. Instruct the patient not
to elevate the head of the bed or
ambulate until the nurse
instructs the patient to do so.
Document teaching in the
medical record.
6. Instruct the patient and family 6. To prevent infection.
to leave the dressing in place for
twenty-four hours. If the
dressing becomes visibly soiled
notify the physician and obtain
an order to change the dressing
using aseptic technique.
Document in the medical
record.
7. Assesses the patient for post-
procedure pain. Provide pain
interventions as needed and
document.
8. For patients not on fluid 8. To help the body eliminate
restriction encourage increased the contrast dye used during
fluid intake for the first 6 to 8 the procedure.
hours.
9. Educate the patient/family on 9. To decrease patient/family
routine post cardiac anxiety.
catheterization care (i.e. vital
signs, activity, diet, etc.) and
document teaching.
10. Document complications in
narrative/progress notes,
including physician notification,
interventions and outcome of
interventions.
4. C-60 Post Coronary Angiography (Cardiac Catheterization) Care Page 4 of 5
MD 11. Provides the patient/family with
updates on how the procedure
went and when to expect test
results.
REFERENCES:
Cardiac Cath Laboratory Policy 8.3.1: Education of Patient and Family
Discharge Instructions: Heart Catheterization Lab. Form S/N 6064
Infection Control Policy: IC16.0 Methods to Prevent Nosocomial Intravascular Device Related
Infections.
Chulay, M., Burns, S., (2007) AACN Essentials of Progressive Care Nursing. McGraw-Hill Co.
Pages 187-188.
5. C-60 Post Coronary Angiography (Cardiac Catheterization) Care Page 5 of 5
Jamie Jett, MBA, RN Date
Administrative Nursing Director
Psychiatry, Coordinated Care and
Professional Practice
Jean DiGrazia, MBA, RN Date
Assistant Hospital Administrator and CNO
Patient Care Services