Cardiac Catheterization Research Paper
Cardiac Catheterization and Kidney Function In many hospitals, the use of cardiac catheterization is used to determine if a patient has occluded arteries or grafts. This procedure saves many lives every day and helps prevent myocardial infarctions in many cases. The procedure itself is rather simple and safe for the most part, but one thing that many fail to realize is how hard the procedure is on kidney function due to the dye used intra-procedure. According to the NIH, kidney damage caused by dye is one of the less common adverse effects ("Cardiac Catheterization," 2012). By understanding the effect of cardiac catheterization on kidney function and implementing the appropriate protocols, hospitals and nurses can help preserve patient kidney
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Lab work is always completed on all patients and history is always reviewed. The facility does administer hydration before the procedure and usually after, but where the facility fails is when patients are discharged home same-day; they do not get the full recommended twelve hours post-procedure hydration. The nurse cannot speak on the amount of contrast dye utilized as that is something not told in report. Acetylcysteine is used in high-risk patients, but not all and it is not a common agent on A8.
To incorporate these standards into practice at this facility, the nurse would have to advocate for the patient and ensure the doctor is aware of current kidney function. The nurse educators could be made aware of the hydration recommendations and have new policies put into place regarding how soon a patient can be discharged post-procedure. Despite the twelve hour hydration recommendation post-procedure, studies show that if contrast-induce nephropathy were to occur, the creatinine would not even start to rise until 24-48 hours after the procedure and would not peak until day 3 (Baez-Escudero, MD & Levine, MD, 2007). Majority of patients seen by the nurse are discharged within 4-6 hours post-procedure and for sure by 24 hours so really the facility is failing at monitoring patients for post-catheterization contrast induced
Lab work is always completed on all patients and history is always reviewed. The facility does administer hydration before the procedure and usually after, but where the facility fails is when patients are discharged home same-day; they do not get the full recommended twelve hours post-procedure hydration. The nurse cannot speak on the amount of contrast dye utilized as that is something not told in report. Acetylcysteine is used in high-risk patients, but not all and it is not a common agent on A8.
To incorporate these standards into practice at this facility, the nurse would have to advocate for the patient and ensure the doctor is aware of current kidney function. The nurse educators could be made aware of the hydration recommendations and have new policies put into place regarding how soon a patient can be discharged post-procedure. Despite the twelve hour hydration recommendation post-procedure, studies show that if contrast-induce nephropathy were to occur, the creatinine would not even start to rise until 24-48 hours after the procedure and would not peak until day 3 (Baez-Escudero, MD & Levine, MD, 2007). Majority of patients seen by the nurse are discharged within 4-6 hours post-procedure and for sure by 24 hours so really the facility is failing at monitoring patients for post-catheterization contrast induced