Coronary angiography: before and after
Before: verify the kidney function and the contrast history, since this is an iodinated contrast procedure. Confirm fasting, the anticoagulation plan, and that the consent is signed for the correct procedure. Mark and document the peripheral pulses distal to the intended access site while the client is still comfortable; this baseline is what makes the post-procedure assessment interpretable. After, radial access: monitor the compression device, the colour, warmth, sensation and movement of the hand, and the appearance of the wrist. Report a hand that becomes pale, cold, painful or numb. After, femoral access: bed rest with the leg straight for the period prescribed. Check the groin site and the pulses at the frequency ordered. Palpate under the buttock and the flank as well, since a retroperitoneal bleed collects where it cannot be seen. Sudden back or flank pain with hypotension and tachycardia is that diagnosis until proven otherwise. Encourage fluids to clear the contrast, monitor urine output, and watch for chest pain, which after this procedure is never dismissed. Teach before discharge: what the puncture site should look like, what to do if it bleeds, and the activity restrictions with a date.