Nursing care planning goals for a child who will undergo cardiac catheterization

Cardiac catheterization is an invasive procedure in which a small flexible catheter is inserted through a vein or artery (usually the femoral vein) into the heart for diagnostic and therapeutic purposes. It is usually done with angiography as radiopaque contrast media is injected through the catheter and visualization of the blood flow is seen on fluoroscopic monitors. Catheterization allows measurement of blood gases and pressures within the heart chambers and great vessels; measurement of cardiac output; and detection of anatomic defects such as septal defects or obstruction to blood flow.
Therapeutic, or interventional, cardiac catheterizations use balloon angioplasty to correct such defects as stenotic valves or vessels, aortic obstruction (particularly re-coarctation of the aorta), and closure of patent ductus arteriosus.Nursing Care Plans
Nursing care planning goals for a child who will undergo cardiac catheterization include promoting adequate perfusion, alleviating fear and anxiety, providing teaching and information, and preventing injury. Close monitoring of a child post cardiac catheterization is also crucial for the early identification of complications that will minimize mortality and morbidity rates.ADVERTISEMENT
Here are four (4) nursing care plans (NCP) and nursing diagnosis for cardiac catheterization:
Ineffective Peripheral Tissue PerfusionHyperthermiaFearRisk For Injury
Ineffective Peripheral Tissue Perfusion
Ineffective Tissue Perfusion: Decreased in the oxygen resulting in the failure to nourish the tissues at the capillary level.
May be related to
Clot formation at the puncture site
Possibly evidenced by
Decreased or absent pulses distal to catheterization siteCool, mottled appearance of the affected extremityTingling sensation on the affected extremityPain
Desired Outcomes
Child’s involved extremity will be pink and warm.Child will respond to sensation in extremities equally bilaterally.Child’s pulses will be present distal to the catheterization site and equal bilaterally.
Nursing Interventions RationaleAssess affected extremity, noting its color, temperature, and capillary refill; Palpate distal pulses; Use doppler every 15 minutes for 4 times, every 30 minutes for 3 hours, then every 4 hours. Formation of a clot at the puncture site and the child is at risk of the clots severely obstructing distal blood and resulting in tissue damage. Frequently assessment of the extremity for adequate perfusion enables for prompt intervention as needed.Encourage bed rest and keep affected extremity straight or slight bend in the knee (10 degrees) for 6 hours. Bed rest and slight, or no flexion, provides improve circulation and minimizes the risk of further trauma which could promote the formation of a clot.Provide warmth to the opposite extremity. Enhances blood flow without causing risk of increased bleeding at the site.Inform parents and child of a need for frequent vital signs monitoring and importance of bed rest with an extension of the extremity. Promotes understanding and cooperation.Hyperthermia
Hyperthermia: Body temperature elevated above normal range.
May be related to
Reaction to the radiopaque contrast substance utilized during catheterization
Possibly evidenced by
Increase body temperature within few hours postoperatively
Desired Outcomes
Child’s axillary temperature will be less than 100° F.

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