Question

After the client's cardiac catheterization where the femoral artery is used as the access vessel, the nurse should: A. Check for allergies to iodine B. Tell the client to refrain from drinking liquids C. Explain the need to flex and extend the leg D. Check the pedal pulse in the operative leg

Short answer

Answer: D. Check the pedal pulse in the operative leg.

Step-by-step solution

Understand cardiac catheterization and femoral artery access

Cardiac catheterization is a procedure to examine the functioning of the heart and its blood vessels. A long, thin tube called a catheter is inserted in an artery or vein, usually in your leg or arm, and passed through to your heart. In this case, the femoral artery (a large artery in the thigh) is used as the access vessel.

Consider the given options

Let's take a look at the proposed nursing interventions: A. Check for allergies to iodine B. Tell the client to refrain from drinking liquids C. Explain the need to flex and extend the leg D. Check the pedal pulse in the operative leg

Rule out irrelevant options

Option A, checking for allergies to iodine, would be important before the procedure, as the contrast dye used may contain iodine. However, since the procedure is already complete in this scenario, this option can be ruled out. Option B, telling the client to refrain from drinking liquids, is irrelevant as there's no direct correlation between fluid intake and complications after cardiac catheterization via the femoral artery. Option C, explaining the need to flex and extend the leg, can be ruled out as usually, the opposite is correct. After the procedure, the client would likely be instructed to keep the leg straight and still for a period of time to prevent bleeding from the puncture site.

Select the correct option

Option D, checking the pedal pulse in the operative leg, is the most important nursing intervention among the given options. This is because cardiac catheterization via the femoral artery could potentially cause complications that impact blood flow to the leg. Assessing the pedal pulse allows the nurse to monitor for signs of reduced blood flow and promptly address any concerns. So, the correct answer is: D. Check the pedal pulse in the operative leg

Key concepts

Femoral Artery Access

During cardiac catheterization, the femoral artery is commonly used as an access point. This is a major artery located in the thigh, making it a popular site due to its size and accessibility.
The procedure involves inserting a catheter through this artery to reach the heart for diagnostic or therapeutic purposes.
Using the femoral artery has several benefits:

• Accessibility: Its size and location make it easy to access with minimal complications.
• Direct path: Provides a direct route to the heart, reducing the time and complexity of the procedure.

Understanding the role of the femoral artery during this process helps recognize potential post-procedure risks, such as bleeding or reduced blood flow to the leg, necessitating careful and vigilant monitoring.

Nursing Interventions

Following cardiac catheterization through the femoral artery, targeted nursing interventions are essential. These interventions aim to ensure patient safety and promote recovery.
Key nursing interventions include:

• Monitoring for signs of bleeding at the catheter insertion site.
• Ensuring the patient's leg remains extended and immobilized to prevent arterial puncture site complications.
• Educating the patient about potential symptoms of complications and when to seek help.

Each of these steps is crucial for preventing adverse outcomes and ensuring a smooth recovery process. Proper education and vigilance are vital for successful post-procedure care.

Post-Procedure Assessment

After the procedure, thorough post-procedure assessments must be conducted to ensure patient well-being. This involves systematic observation and evaluation to identify any complications early.
Core components of the post-procedure assessment include:

• Checking for any signs of bleeding or hematoma at the access site.
• Assessing vital signs to monitor for cardiovascular instability.
• Reviewing the patient's discomfort or pain levels to address adequate pain management.

Each of these assessments assists in detecting potential issues quickly, allowing for prompt and effective intervention to maintain the patient's overall health.

Pedal Pulse Monitoring

Monitoring the pedal pulse is a critical nursing action after using the femoral artery for catheterization. The pedal pulse is located on the top of the foot, and assessing it helps determine blood circulation adequacy to the lower extremities.
Why it matters:

• Ensures proper blood flow is maintained, reducing the risk of complications from arterial blockage.
• Helps recognize early signs of reduced arterial flow, such as pallor or coolness in the limb.
• Provides immediate feedback on the patient’s vascular status post-procedure.

Regular monitoring and understanding how to assess the pedal pulse effectively are crucial skills for nurses managing patients after cardiac catheterization. This ensures any circulatory impediment is promptly addressed, preventing serious complications.