Overview
The Post-Procedure Picture
Coronary angiography introduces a catheter through an artery—most often the radial artery at the wrist or the femoral artery in the groin—to image coronary vessels.
Coronary angiography introduces a catheter through an artery—most often the radial artery at the wrist or the femoral artery in the groin—to image coronary vessels. If angioplasty or stent placement occurs, the patient has also undergone percutaneous coronary intervention (PCI). The nursing priorities overlap, but PCI adds concern for recurrent ischemia and interruption of antiplatelet therapy. The first hours after the procedure are a surveillance period. Arterial puncture, anticoagulation, antiplatelet therapy, contrast exposure, and catheter manipulation can produce complications that initially look minor: a small swelling, vague back discomfort, nausea, or a slightly lower blood pressure. An experienced nurse looks for a pattern rather than waiting for one dramatic sign. Assess serial vital signs; the access site; distal circulation, sensation, and movement; pain; urine output; cardiac rhythm; and symptoms of myocardial ischemia. Frequency is greatest soon after sheath removal or device deployment, then decreases only when the patient remains stable under the prescribed post-procedure protocol. Within the RPN’s authorized scope and organizational policy, complete ordered or protocol-based assessments, recognize deterioration, begin immediate safety measures, and escalate promptly to the RN,...