what really matters? - ijn collegeijncollege.edu.my/pdf/bcl-basic cath lab symposium.pdf · •...
TRANSCRIPT
![Page 1: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/1.jpg)
What really matters?
Your Heart…Our Passion
![Page 2: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/2.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
![Page 3: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/3.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
![Page 4: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/4.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
![Page 5: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/5.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
![Page 6: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/6.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 1: Anxiety/Fear
Diagnosis Criteria Cause Aim
• ↑ blood pressure (BP),
pulse rate and number of
breaths
• Tension, irritability,
nervousness, crying
• Headache, light headedness
• Palmar sweating
• Attention deficit
• Pupillary dilation
• Dyspnea
• Palpitation
• Dry mouth
• Frequent urination
• Tingling in hands and feet
Having one-sided,
exaggerated and
negative information
on interventional
treatment process,
outcomes and
potential
complications.
• Decreasing the
patient's anxiety/fear,
• Developing
effective
ways of coping with
stress.
![Page 7: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/7.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 1: Anxiety/Fear
Interventions Assessment
Anxiety level of the patient is assessed
• The ways the patient uses for coping with
stress are identified.
• Causes of anxiety/fear are investigated
• Clear and understandable words are
used during the education,
• Communication with other patients
• Help is provided for the patient while
implementing techniques to decrease
anxiety
• Sedative drugs can be given the night
before the procedure according to the
physician’s orders.
Expected Outcomes
• Expression of decrease in
anxiety/fear by the patient,
• Use of relaxation methods
effectively by the patient,
• Decrease in symptoms of
psychomotor agitation
![Page 8: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/8.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 2: Knowledge Deficit
Diagnosis Criteria Cause Aim
Being willing to get more
information,
• Asking more or less
questions,
• ↑anxiety,
• Restlessness
Having inadequate
information about
the process
planned to be
performed.
• Decreasing the
patient's anxiety
• Increasing level of
knowledge
![Page 9: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/9.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 2: Knowledge Deficit
Interventions Assessment
• Definition of PCI is done by the
cardiologist
• Pre-interventional education
Expected Outcomes
• Definition of PCI is made
by the physician,
![Page 10: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/10.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 3: Safe Preparation
Aim
To prepare the patient safely for PCI
Interventions • Investigations
• informed written consent form
• Radial and groins are shaved bilaterally
• Vital signs are checked,
• Dentures, accessories and nail polish are removed,
• Intravenous access is achieved,
• Medications are given according to the physician's order,
• The patient puts on a cap and a gown and wears an identity wrist band,
• The patient is taken to the cath laboratory
![Page 11: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/11.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 4: Chest Pain
Diagnosis Criteria Cause Aim
The patient expresses pain,
• The patient is restless and
anxious,
• Pain lasts less than 20
min. in ischemic events
without necrosis,
• ECG changes
• Increase markers
• Presence of hemodynamic
instability
Myocardial chest
pain occurs when
coronary perfusion
is relatively
inadequate as a
result of absolute
or increased need
of supply. Chest
pain is a sign of
severe ischemia.
Pain starts before
necrosis develops
and disappears if
ischemia ends or
worsens if ischemia
continues.
• Alleviation of pain,
• Supporting the
circulation.
![Page 12: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/12.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 4: Chest Pain
Interventions Assessment
• Characteristics of myocardial ischemia
are evaluated,
• BP and pulse are evaluated,
• Medications are given according to the
physician's orders
• Effectiveness of treatment is monitored,
• ECG changes accompanying pain are
monitored,
• The patient is followed-up for arrhythmia,
• 12-lead ECG is done,
• Oxygen is given (SaO2 is held over 92%),
• Urine volume is checked.
Expected Outcomes
• Absence of pain,
• Absence of Q wave in
12-lead ECG,
• Systolic BP >90 mmHg,
• Heart rate 60-100 bpm,
• No elevation of markers
such as cardiac enzymes.
![Page 13: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/13.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 5: Arrythmias
Diagnosis Criteria Cause Aim
• Changes in ECG,
• Consciousness disorder,
• Extreme increase or
decrease or irregularity of
pulse rate and/or
decrease in amplitude,
• Pale, cold or damp skin.
• Inability to deliver
sufficient O2 to the
myocardium
• Type of contrast
medium given,
• Rapid infusion or
infusion of too
much contrast
medium,
• Electrolyte
imbalance
• Preventing the
development of
arrhythmia,
• Eliminating
arrhythmia,
• Keeping the
arrhythmias that
cannot be
eliminated within
an acceptable
range.
![Page 14: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/14.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis : Arrthymias
Interventions Assessment
• Vital signs are assessed,
• Level of consciousness is assessed,
• Pulse is checked • Skin perfusion is
evaluated,
• Emergency medications should be ready
for use,
• Transient pacemaker is held ready for
use,
• Medical therapy
Expected Outcomes
• Stabilization of cardiac
rhythm.
![Page 15: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/15.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 6: Decreased Cardiac
Output
Diagnosis Criteria Cause Aim
• Tachycardia,
• Hypotension,
• Restlessness,
• Light headedness,
• Cold and damp skin,
• High-pitched fine
crepitation in the
pulmonary region,
• Urine volume of <30 ml/h,
• Increasing pulse
amplitude,
• Capillary filling time of >3
sec.
• Decrease in
circulating volume,
• Blood loss,
• Cardiac tamponade,
• Arrhythmia,
• Myocardial ischemic
dysfunction or
necrosis
(myocardial infarction),
• Early diagnosis of
symptoms and
signs showing a
decrease in cardiac
output,
• Prevention of
complications,
• Increasing cardiac
output to the normal
level.
![Page 16: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/16.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 6: Decreased Cardiac
Output
Interventions Assessment
• Hemodynamic status is closely monitored,
• 12-lead ECG is done and evaluated,
• If chest pain is present physician is informed,
• Cardiac enzymes markers are monitored
• Hourly and daily fluid I/O are monitored,
• Urine volume of than less is reported to
the physician,
• Oral feeding of the patient is restricted
• Necessary medications according to the
physician's order
• The patient is assessed for symptoms such
as disorientation, confusion, fatigue,
increasing restlessness.
Expected Outcomes
• Obtaining adequate
cardiac output; warm
and dry skin,
• Normal BP,
• Pulse rate of 60-100
bpm,
• Absence of crepitation,
• Normal PCWP,
• Urine volume of more
than 30 ml/h.
![Page 17: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/17.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 7:
Decreased in Peripheral Tissue Perfusion
Diagnosis Criteria Cause Aim
• Decrease or absence of
pulse amplitude in the
affected extremity,
• Capillary filling time of >3
sec. in the affected
extremity,
• Pallor, mottling and
cyanosis developing at the
distal region of the affected
extremity,
• Decrease in voluntary
movements and senses.
•Mechanical obstruction
in the arterial cannula,
• Arterial vasospasm,
• Thrombus formation,
• Embolization,
• Immobility,
• Bleeding /hematoma.
• Providing
adequate
peripheral tissue
perfusion.
![Page 18: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/18.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 7:
Decreased in Peripheral Tissue Perfusion
Interventions Assessment
•Before Cannula Removal
• Presence and quality of the pulse are
assessed and recorded,
• Unpalpable pulses are checked by Doppler
ultrasound
• Colour and temperature of all four
extremities are assessed and recorded,
• All extremities are assessed
• Bed rest is provided,
• The cannulated extremity is held straight
with the aid of knee and leg immobilizers,
• The patient is not allowed to be in a seated
position
Expected Outcomes
• Palpable pulses,
• Disappearance of
ischemic pain,
• Presence of senses,
warm and pink skin at
the extremity.
![Page 19: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/19.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 7:
Decreased in Peripheral Tissue Perfusion
Interventions Assessment
After Cannula Removal
• Presence and quality of pulses at the distal
of the extremity with an arterial cannula are
evaluated
• Site of intervention is assessed for swelling
and hematoma formation,
• Development of pseudoaneurysm and
arteriovenous fistula is assessed (a pulsatile
mass, systolic inguinal pain, systolic
murmur),
• The patient is prepared for surgical
intervention when needed
Expected Outcomes
• Palpable pulses,
• Disappearance of
ischemic pain,
• Presence of senses,
warm and pink skin at
the extremity.
![Page 20: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/20.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 8: Bleeding
Diagnosis Criteria Cause Aim
• External bleeding,
• Internal bleeding (into
anatomical spaces or
within tissues)
• Swelling due to bleeding
(hematoma formation)
• Hemorrhagic diathesis
due to treatment or
patient characteristics,
• Use of wide cannula,
• Inadequate pressure
applied on the site of
intervention.
• Prevention of
bleeding,
• Stop the bleeding,
• Elimination of
complications of
bleeding.
![Page 21: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/21.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 8: Bleeding
Interventions
• Site of intervention is followed for bleeding (blood on bandage, pain,
swelling, hematoma),
• Symptoms and signs of retroperitoneal bleeding are monitored (side pain,
decrease in amplitude of extremity pulses, decrease Hb levels),
• After the procedure vital signs are monitored until they are stabilized (BP
and pulse may be indicators of bleeding),
• Prothrombin time, partial thromboplastin time, activated coagulation time
(ACT) and platelet levels are monitored.
![Page 22: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/22.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 8: Bleeding
Interventions
•If there is significant bleeding;
- Vital signs are monitored every 15 minutes until bleeding is
controlled,
- Circulation of the extremities is checked,
- Amount of blood on the bandage is evaluated and recorded,
- If hematoma is present, it is marked on the skin starting from the
outer borders.
![Page 23: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/23.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 8: Bleeding
Interventions
Before Cannula Removal;
- The limb is held straight in a resting position,
- The head of the bed is elevated with an angle of less than 30 degrees,
- A suitable position for feeding, excretory functions and necessary
position changes are provided,
- Frequent movements of the limb on which the intervention is done are
avoided,
• The patient is taught to apply pressure on the site of intervention during
coughing, sneezing and head elevation with a pillow,
• The patient is told to inform the nurse when he/she feels temperature
rise, dampness or swelling at the site of intervention,
• Antiplatelet drugs are ceased according to the physician's order
![Page 24: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/24.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 8: Bleeding
Interventions
If there is serious bleeding;
- The physician is informed,
- Infusion of anticoagulants (heparin, low molecular weight heparin),
antiaggregants(GPIIB/IIIA receptor blockers) and fibrinolytic agents is
ceased after consulting the physian,
- Bandage at the bleeding site is changed; manual or mechanical
pressure is applied,
- The cannula is removed by the physician if necessary,
- Fluid infusion is started according to the physician's order.
![Page 25: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/25.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 8: Bleeding
Interventions
Following Cannula Removal;
- Pressure is applied for 20-30 minutes
- Bed rest in supine position is provided according to the clinical protocol,
- Sudden movements are avoided until wound closure and clot formation
- is complete,
- Mobilization of the patient is started according to the clinical protocol.
![Page 26: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/26.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 9: Allergic Reaction
Diagnosis Criteria Cause Aim
• Pruritus, urticaria,
• Rash,
• Feeling of warmth,
• Dyspnea,
• Fever,
• Anaphylaxis.
• Contrast medium
use.
• Prevention and
diagnosis of
allergic reaction
and symptomatic
treatment.
![Page 27: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/27.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 9: Allergic Reaction
Interventions Assessment
• Allergy against contrast medium is
investigated,
• The patient is told to give information in case
of:
- Pruritus, feeling of warmth
- Nausea and vomiting, malaise
- Dyspnea
• Vital signs are closely monitored,
• Antihistamines/corticosteroids are given
• Life supporting measures are taken if the
reaction is severe,
• Psychological support is provided for the
patient.
Expected Outcomes
• No signs of allergic
reactions are
observed in the
patient.
![Page 28: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/28.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 10: Restriction of Movements
Diagnosis Criteria Cause Aim
•Activity restriction
necessary for the
intervention,
• Limited movement at the
site of intervention.
•Ensuring activity
restriction.
![Page 29: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/29.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
Nursing Diagnosis 10: Restriction of Movements
Interventions Assessment
• Reasons of activity restriction are explained
to the patient,
• Training for activity restriction is given;
- Bed rest for 12-24 hours,
- Immobilization of the extremity
- Head elevation of less than 30 degrees
- Applying manual pressure during bowel
movements, coughing, sneezing and
supporting the head with a pillow,
• Log-rolling technique is used
• The body is supported by pillows while being
positioned,
• Materials are kept within the reach of the
patient
• gradually mobilize
Expected Outcomes
• Providing activity
restriction suitable
for the patient.
![Page 30: What really matters? - IJN Collegeijncollege.edu.my/PDF/BCL-Basic cath lab symposium.pdf · • Cardiac tamponade, • Arrhythmia, • Myocardial ischemic dysfunction or necrosis](https://reader031.vdocuments.site/reader031/viewer/2022022804/5c91cc7a09d3f244438c6473/html5/thumbnails/30.jpg)
Click to edit Master title style INSTITUT JANTUNG NEGARA
National Heart Institute
References
1) Freed M, Gines C. Manual of Interventional Cardiology. 2nd Edition. Michigan:Physician’s Press Birmingham; 1992.
2) Hillis LD, Lange RA, Winniford MD, Page RL. Kardiyolojide Klinik Problemler El Kitab›(Manual of Clinical Problems in Cardiology);
Editör: Hisar ‹. Ankara: Bilimsel T›pYay›nevi; 1996. p.167-76.
3) Oral D, Ömürlü K. Koroner anjiyoplastide yeni teknolojik uygulamalar (New technological applications in coronary angioplasty).
Kardiyoloji 1994;1:64-85.
4) Türk Giriflimsel Kardiyoloji Dergisi (Turkish Journal of Interventional Cardiology)2000;4(3):129-81.
5) Oto A, Oktay E. Türkiye’de giriflimsel kardiyoloji alan›nda yaflanan sorunlar vemuhtemel çözüm önerileri (Problems and
recommendations for potential solutions oninterventional cardiology in Turkey). T›p Dünyas› 2003;(98):1-4. http://www.ttb.org.tr
6) Braunwald ZL. Heart Disease. A Text Book of Cardiovascular Medicine. 6th Edition.Philadelphia: WB Saunders Company; 2001.
p.1364-92.
7) Reynolds S, Waterhouse K, Muller HC. Head of Bed Elevation, Early Walking, and Patient Comfort After Percutaneous
Transluminal
Coronary Angioplasty. Dimensions ofCritical Care Nursing 2001:44.
8) Topol EJ. Textbook of Interventional Cardiology. 4th Edition. Philadelphia: WB Saunders Company; 2003. p.141-63.
9) Donald SB. Coronary angioplasty. In: Cardiac Catheterization, Angiography and Intervention. 5th Edition. Philadelphia:
Williams&Wilkins; 1996. p.537-62.
10) Apple S, Lindsay J. Giriflimsel Kardiyoloji (Interventional Cardiology). ‹stanbul: Nobel T›p Kitabevleri; 2003. s.9-213.
11) Stephen GE. Elective coronary angioplasty: technique and complications. In: Cardiac Catheterization, Angiography and
Interventions.
5th Edition. Philadelphia: Williams &Wilkins; 1996. p.186-201.
12) Ulrich S. An overview of intravascular stents: old and new. In: Cardiac Catheterization,Angiography and Interventions. 5th
Edition.
Philadelphia: Williams & Wilkins; 1996. p.812.
13) Pepine CJ, Hill JA, Lambert CR. Diagnostic and Therapeutic Cardiac Catheterization.Baltimomer: Williams & Wilkins; 1994.
p.471-
598.
14) Urden LD, Stacy KM. Priorities in Critical Care Nursing. 3rd Edition. Philadelphia:Lippincott Company; 2000. p.194-7.
15) Binak K, ‹lerigelen B, Güzelsoy D, Okay T. Teknik Kardiyoloji (Technical Cardiology).2nd Edition. ‹stanbul; 2001. p.355-67.
16) Davies C, Van Riper S, Long Street J. Vascular complications of coronary interventions, heart & lung. The Journal of Acute &
Critical
Care 1997;26(2):118-27.
17) Woods S, Frolicher ES, Motzer SU. Cardiac Nursing. 4th Edition. Philadelphia: Lippincott Williams & Wilkins; 2000. p.544-57.
18) Hartshorn JC, Sole ML, Lamborn ML. Introduction to Critical Care Nursing. 2nd Edition. Philadelphia: WB