Megacode Case Study: PTCA/Cardiac Cath

Better Essays
MegaCode Case Study
Chamberlain College of Nursing
Professor Amber Essman
Critical Care (NR 340)
July 11, 2013

MegaCode Case Study 1. Describe the preoperative and postoperative care of a client having PTCA/cardiac cath. What complications can occur post cardiac cath?
The goal of PCI (percutaneous Transluminal intervention) is to open the blockage in the coronary artery. By opening the area that is blocked, it will help to reperfuse the myocardium. The faster this is done will help limit the amount of damage. This procedure should be done within 90mins of the patient arriving in the ED. Preoperatively, the nurse will need to ensure that the patient understands the procedure and has signed a consent form. The nurse will also need to gather a medical and medication history and any reactions to medications. The nurse will also check for labs, such as blood urea nitrogen and creatinine levels. The patient will need an IV placed. The arterial pulses in both legs (femoral, popliteal, dorsalis pedis, and posterior tibial) should be checked and documented using a scale of 0 to 4. The nurse should also explain what the patient will be experiencing during the procedure. The patient will be awake but will receive analgesics and sedatives.
…show more content…
When discharging the patient, teach them to monitor for s/s of MI or angina, infection, bleeding. This includes fever, swelling, oozing or bruising around cath site. The patient should also report numbness, tingling or pain in the leg used for the procedure as this might indicate a thrombosis. The patient will be taking medication, such as: antiplatelet medication (aspirin or clopidogrel) a statin and a beta blocker. The patient should also be taught to avoid pressure on the cath site, avoid lifting things heavier than 10lbs for two weeks and not to drive for a few days after the

You May Also Find These Documents Helpful

  • Better Essays

    T.W. initial assessment and to stabilize him will be the priority following ABCs. The neurologic assessment every hour will provide T.W. general condition and information that can determine any changes. Oxygen will be given at 4 L per nasal cannula. The next will be stabilization of spine by immobilize the cervical spine to protect the spine and from causing more trauma. The preparation to administer fluid to maintain hemodynamic stability therefore, initiate two large bore IVs. An ECG monitor will be connected to record and detect heart conduction, disturbances or hyperkalemia. Also, a Foley catheter will be inserted that will assist T.W. with voiding and lastly, apply warm blanked as needed to prevent hypothermia and to maintain his temperature.…

    • 1601 Words
    • 6 Pages
    Better Essays
  • Better Essays

    Nursing Research

    • 1374 Words
    • 6 Pages

    Predictors of vascular complications post diagnostic cardiac catheterization and percutaneous coronary interventions. Dimension of Critical Care Nursing, 25(3), 137-142. Retrieved from http://journals.lww.com…

    • 1374 Words
    • 6 Pages
    Better Essays
  • Good Essays

    She will be instructed not to eat or drink to minimize the risk of complications such as pulmonary aspiration and vomiting during the operation (Liddle, 2014). Before Audrey goes to the operating room, nurses must check the contents of the medical record to be sure that appropriate laboratory result are available as well as her fluid balance charts, medications and x-ray results. Also, nurses must ensure that informed consent has been obtained, as it is a medical-legal and clinical aspect of health care practice and the current progress notes must be charted as well as her allergy for Bactrim. Current vital signs must be taken and recorded as well. If pre operative vital signs are abnormal, notify the doctor straight away as it may increase Audrey’s surgical danger. Basic personal hygiene such as bathing will be performed or applying antiseptic agent on the skin at the incision site. It lessens the number of bacteria on the skin and reduces the risk of developing surgical site infection. Also, mark her left hip for the incision site. Audrey will also be checked and documented for any prosthetic device such as dentures and hearing aids to prevent damaging of the item during the surgery. Moreover, pre operative medications will be administered as per doctor’s order to reduce Audrey’s anxiety, lessen the chances of having nausea and vomiting and respiratory tract secretions (Taylor, 2009). Lastly, promote a restful and comfortable environment and offer her a…

    • 1908 Words
    • 8 Pages
    Good Essays
  • Good Essays

    5 parts of the run

    • 607 Words
    • 3 Pages

    c. Circulation-pulse; assess if there is a pulse or no pulse if no pulse in wrist (80mmHg) go to brachial (70mmHg) then carotid (60mmHg) determine the regularity and strength(EKG), possible major bleeding; control any arterial bleeding or venous bleeding by placing gloved hand and then getting pressure dressing, skin color: assessing color, temperature and condition, capillary refill (immediate2sec).assess, intervene, reassess…

    • 607 Words
    • 3 Pages
    Good Essays
  • Best Essays

    Core Skill: Blood Pressure

    • 2639 Words
    • 11 Pages

    The Association of Anaesthetists of Great Britain and Ireland (AAGBI 2010) Pre-Operative Assessment: The Role of The Anaesthetist 2 [Online] Available at: http://www.aagbi.org/publications/publications-guidelines/P/P…

    • 2639 Words
    • 11 Pages
    Best Essays
  • Good Essays

    This next step is where a lot of phlebotomist can make their first mistake. After the tourniquet is in place, you must palpate for the phlebotomy, site to feel for a vein. Most phlebotomist will say “Oh I can't see any veins" that would be because we are supposed to palpate for the vein not go by sight. The vein may look good but in reality it could be a thready (small), rolling, or a vein that has been used to often and would collapse. Most likely this could cause the phlebotomist to miss the vein. Then cleanse the area with an alcohol pad and insert the needle at a 15° angle with the bevel up (bevel is the where the needle becomes flat with small hole or bore showing to the a point) until a flash of blood and draw the specimen according to the tests ordered. To finish up I would then take the tourniquet off, remove the last vial and apply a gentle pressure while removing the needle from your patients arm, then bandage. Remember to educate your patient about bruising.…

    • 524 Words
    • 3 Pages
    Good Essays
  • Good Essays

    There are pharmacological and non pharmacological ways to protect patients in the hospital setting. Using these in conjunction with each other is the overall safest method. Non pharmacological methods of VTE prophylaxis include early ambulation, sequential compression devices (SCD), and compression stockings. Early ambulation promotes venous return and helps minimize length of stay in hospitals. Compression stockings and SCDs help prevent venous stasis. A recent systematic review found that graduated compression stockings, intermittent pneumatic compression devices, and foot pumps reduce the risk of DVT in surgical patients by two thirds when used in monotherapy and by an additional 50% when added to drug prophylaxis (Roderick et al., 2005). Pharmacological methods of VTE prophylaxis include anticoagulants such as low molecular weight…

    • 789 Words
    • 4 Pages
    Good Essays
  • Satisfactory Essays

    Discharge summary Case 1

    • 225 Words
    • 2 Pages

    The patient was discharged on post-operative day number three, after having had a normal bowel movement. She was discharged without complaints, on no medications. She understood her instructions regarding: follow-up, incision care and limitation of activities.…

    • 225 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Chapter 050

    • 4907 Words
    • 28 Pages

    3. Which nursing action will be included in the postoperative plan of care for a patient who…

    • 4907 Words
    • 28 Pages
    Satisfactory Essays
  • Powerful Essays

    CHG 3000 Vaining

    • 3965 Words
    • 16 Pages

    There will be no ointments allowed to be used in the study such as any antimicrobial creams as it will give false result. Removal of the lines will be needed if it is not necessary or if patient has developed signs of catheter related bloodstream infection such as persistent symptoms of redness and pus, leading to an invasive lines related bloodstream infection (Langgartner 2004).…

    • 3965 Words
    • 16 Pages
    Powerful Essays
  • Powerful Essays

    This paper will look at 5 different prophylactic methods for prevention of deep vein thrombosis post operative, which will include: The effectiveness of anti embolic stockings, the use of intermittent pneumatic compression device, effectiveness of combined anti-embolic stockings and intermittent pneumatic compression (mechanical methods), the use of pharmacological prophylaxis - low molecular weight heparin, and the effectiveness of combined mechanical and pharmacological methods.…

    • 1593 Words
    • 7 Pages
    Powerful Essays
  • Satisfactory Essays

    DVT Case Studies

    • 248 Words
    • 1 Page

    Thank you for sharing your experience, Dr. Potter. This incidence is also really eye opener for me too. I concur on your statement that Physical Therapist (PTs) should overly cautious after post operative case in ordered to prevent acute post operative complications. Especially, Deep Vein Thrombosis (DVT) often asymptomatic, making screening (special tests, Well's clinical decision rules for DVT) a key part in avoidance of this potentially life-threatening dilemma (Goodman and Synder,2007).…

    • 248 Words
    • 1 Page
    Satisfactory Essays
  • Good Essays

    Assess the neurologic function; focus on early changes in level of consciousness, Monitor for signs of herniation (abnormal posturing movements, such as decerebration, decortications, and flaccidity, to noxious stimuli). Maintain adequate fluid intake to prevent dehydration. Maintain adequate nutrition. Position the patient to prevent joint stiffness and neck pain.…

    • 732 Words
    • 3 Pages
    Good Essays
  • Satisfactory Essays

    Chest Pain Care Plan

    • 355 Words
    • 2 Pages

    Risk for ineffective peripheral tissue perfusion to right leg related to catheterization procedure as evidenced by interruption of arterial flow.…

    • 355 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    Application of Dikw

    • 921 Words
    • 4 Pages

    Venous Thromboembolism (VTE) also known as and often referred to as deep vein thrombosis is a high risk diagnosis that can often lead to Pulmonary Embolism, both of which can occur due to trauma or as a result from a complication due to a high risk surgery; both of which have a significant morbidity and mortality. Factors that contribute to this event are the slow venous blood circulation increasing the risk for blood clotting or endothelium trauma which also increases the risk for a thrombolytic event. The current treatment consists of mechanical compression to improve circulation by preventing venous stasis or pharmacological intervention in the form of anti-coagulants to inhibit platelet aggregation. The treatment with one of both of the above mentioned method can help to prevent the development of a thrombolytic event. Venous thrombolytic events are highly likely to happen following a surgical complication (Kakkos, 2012).…

    • 921 Words
    • 4 Pages
    Good Essays