Introduction A coronary angiogram, also called coronary angiography, is an X-ray procedure used to look at the arteries in the heart. In this procedure, a dye (contrast dye) is injected through a long, hollow tube (catheter). The catheter is about the diameter of a piece of cooked spaghetti and is inserted through the groin, wrist, or arm. The dye is injected into each artery, and X-rays are then taken to show if there is a blockage in the arteries of the heart. Tell a health care provider about: Any allergies you have, including allergies to contrast dye. All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines. Any problems you or family members have had with anesthetic medicines. Any blood …show more content…
disorders you have. Any surgeries you have had. History of kidney problems or failure. Any medical conditions you have. Whether you are pregnant or may be pregnant. What are the risks? Generally, this is a safe procedure. However, problems may occur, including: Infection. Allergic reaction to medicines or dyes. Bleeding from the access site or other locations. Kidney injury, especially in people with impaired kidney function. Stroke (rare). Heart attack (rare). Damage to other structures or organs. Death (rare). What happens before the procedure? Staying hydrated Follow instructions from your health care provider about hydration, which may include: Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea. Eating and drinking restrictions Follow instructions from your health care provider about eating and drinking, which may include: 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods. 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal. 2 hours before the procedure – stop drinking clear liquids. General instructions Ask your health care provider about: Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners. Taking medicines such as ibuprofen.
These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to, though generally aspirin is recommended prior to coronary angiograms. The risks and potential problems associated with the procedure. What happens during the procedure? An IV tube will be inserted into one of your veins. You will be given one or more of the following: A medicine to help you relax (sedative). A medicine to numb the area where the catheter will be inserted into an artery (local anesthetic). The area where the catheter will be inserted will be shaved and cleaned. This is often done in the groin but may be done in the fold of your arm (near your elbow) or in the wrist. The health care provider will insert the catheter into an artery. The catheter will be guided by using a special type of X-ray (fluoroscopy) of the blood vessel being examined. A special dye will then be injected into the catheter, and X-rays will be taken. The dye will help to show where any narrowing or blockages are located in the heart arteries. What happens after the procedure? If the procedure is done through the leg, you will be kept in bed lying flat for several hours. You will be instructed not to bend or cross your
legs. The insertion site will be checked frequently. The pulse in your feet or wrist will be checked frequently. Additional blood tests, X-rays, and an electrocardiogram may be done. CancelCopy and Navigate
Diprivan: Relaxes and sedates the patient before surgery / In order to insert the IABP and intubation on the patient.
Cardiomyopathy, by definition, means the weakening of the heart muscle. The heart is operated by a striated muscle that relies on the autonomic nervous system to function. Cardiomyopathy is diagnosed in four different ways based on what caused the illness and exactly what part of the heart is weakened. The four main types of cardiomyopathy are dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrhythmogenic right ventricular dysplasia. One other category of cardiomyopathy that is diagnosed is “unclassified cardiomyopathy.” Unclassified cardiomyopathy is the weakening of the heart that does not fit into the main four categories.
Then after threading a catheter through the needle, the anesthesiologist will withdraw the needle and leave the catheter i...
An artery is an elastic blood vessel that transports blood away from the heart. There are two main types of arteries: pulmonary arteries and systemic arteries.
Acute coronary syndrome pertains to a sudden changes in the heart’s blood supply. It can range from the development of
Keep the patient NPO, and establish two IV access sites with a large bore catheters running one IV with NS at KVO and morphine sulfate for pain. Initial laboratory testing including a complete blood cell count (CBC), basic metabolic panel (BMP), cardiac enzymes (creatine kinase, creatine kinase-MB, and cardiac Troponin) and repeat in 90 min. Administer antiplatelet ASA 324mg PO (Sen, B., McNab, A., & Burdess, C., 2009, p. 18). Before administering nitroglycerin 0.4 mg SL (every 5 minutes up to three doses) reassess blood pressure if systolic <90 mmHg, patient has used cocaine in the last 24 hours, or taking PDE-5 inhibitors do not administer. Thrombolytic therapy should be implemented within 30 minutes from the patient’s arrival to the emergency department, and if they are a candidate for cardiac catheterization it should be done within 90 minutes from the patient being admitted to the hospital. Delay on either therapy option increases the risk of mortality (Kosowsky, Yiadom, Hermann, & Jagoda, 2009, p. 10).
Oxygen is vital to a beating, healthy heart because it is needed to perform cellular respiration in order to pump the blood. When there is no oxygen being transported to the heart, the heart cannot pump blood, and eventually after being inactive, the heart tissue dies . This results in a heart attack. Heart attacks can be diagnosed before it is too late. One method of diagnosis is through a blood test. Blood tests are capable of sorting through the material found in blood, and if heart cell contents are found in the specimen, a heart attack can be diagnosed. If the levels of the cell contents are higher, this signifies that the heart attack is more severe. Another method of diagnosis is an electrocardiogram (ECG). An ECG measures the rhythm of the heart in order to detect defects. There are many other strategies that are used by doctors in order to diagnose a heart attack, such as chest x-rays, stress tests, tilt table tests, and echocardiograms, to name a few. A myocardial biopsy involves looking at the heart cells, and is accomplished by collecting a sample of heart cells from the patient. If the results are positive, a heart attack is diagnosed. A heart MRI involves looking at images of the heart in order to detect heart failure. The doctor uses the images to look for disorders in the structure of the
...e operating table and the nurse anesthetist begins to place the monitors on them. Next, everyone in the room confirms the patient’s name and the scheduled operation. Then the nurse anesthetist puts the anesthesia in the patient’s IV. Once the patient is asleep, the CRNA manages his/her airway. To do this they place an endotracheal tube through the patient’s mouth, allowing them to breathe anesthesia gases. Now the operation can begin.
(Slide 2) What is Cardiomyopathy? If we break down the word we can see “Cardio” which means of the heart, “myo” which means muscle, and “pathy” which means disease, therefore cardiomyopathies are diseases of the heart muscle. (Slide 3) There are 3 main types of cardiomyopathies; hypertrophic, dilated, and restrictive. I will only be discussing dilated cardiomyopathy, which is characterized by the enlargement of the hearts chambers with impaired systolic function. It is estimated that as many as 1 of 500 adults may have this condition. Dilated cardiomyopathy is more common in blacks than in whites and in males than in females. It is the most common form of cardiomyopathy in children and it can occur at any age (CDC).
Atherosclerosis is a disease that occurs when arteries become blocked, inflamed, or hardened. As a result of this, blood cannot easily pass through the artery, and blood pressure increases. Many people suffer from atherosclerosis as they age, but young people can be affected by atherosclerosis also. There are many preventative steps that can be taken to decrease the risk of atherosclerosis; however, if atherosclerosis does develop in the arteries, medications can be given to help the individual receive adequate blood flow to important tissues. Atherosclerosis is a very serious condition that requires medical attention and a change in life style because it is a precursor to many dangerous and potentially fatal diseases.
...f the clamps on the tubing to allow the IV solution to run freely. Slowly, decrease the flow of the solution to the appropriate rate as ordered by the physician. Using a small gauze pad, wipe away any excess blood or fluid on the surface of the skin. Then, using the pre-torn pieces of tape, secure the catheter hub and the IV tubing to the patient’s skin. Take extra caution not to kink the tubing. Once everything is secured, recheck the IV solution’s flow and then attend to the rest of your patients needs.
Oxygen was first admitted to the client with chest pain over 100 years ago (Metcalfe, 2011). Chest pain is a large bracket that can contain many different conditions, but for the purpose of this analysis it is focused manly upon a myocardial infarction. A myocardial infarction is mainly referred to as a heart attack, and occurs when one or more coronary arteries leading to the heart reduce or completely stop blood flow (Tuipulotu, 2013 ). Administering high concentrations of oxygen to patients with chest pain is now embedded in guidelines, protocols and care pathways, even with a lack of clear supporting evidence (Nicholson, 2004 ). High concentration of oxygen means that up to 60% is administered (Knott, 2012). More recent research has suggested that the use of oxygen in this scenario is unnecessary and can lead to unwanted side effects, especially in normoxic cardiac patients (Moradkham & Sinoway, 2010 ). The aim of this comparative analysis is to dismantle and understand both the benefits and risks of the commonly known practice of administration of oxygen to the client with chest pain. Through completing this analysis using recent and appropriate evidence a more improved practice can be given and understood.
Upon the patients arrival you will - need to prep the surgery cite marked by the surgeon. You will do this by the following cleaning and disinfecting procedures. During the surgery, you will be following instruction from the surgeon. As the doctor request a certain instrument you will give or take back instruments being used. This could also include sutures or lap-sponges. In certain procedures you may also be asked to hold organs or re-tractors to get the surgery done. After the surgery you will assist in applying dressings to protect the incision-cite. Upon completion of the surgery all the instruments and sponges used are accounted for. The purpose of this is to make sure none were left in the patient. Then the instruments will be taken to sterile processing department and the sponges would be disposed of properly. You have to be very safe, delicate, and vigilant with your work environment because you have a person’s life in your hands. Then we would continue to clean the room using special cleaners and disinfectants to get the room ready for your next case. Each doctor can request different room setups so it is important you refer to the surgeon procedure card. Depending on the severity of the procedure you could have between one to four cases a
...e process, the medical assistant will blot the closure with gaze. This will remove any blood from the area being sutured. Keeping the area clean and sterile is vital. After suturing, the area is cleaned and a sterile bandage applied. The patient is instructed to not get the area wet, return in 3 day for dressing change. I the patient feel any irritation, swelling, or see redness around the area, please call the doctor’s office. We do not want the area to get infected. Bleeding, swelling, fever, pain are all things that should be reported. The patient is instructed to return in 7 days for suture removal. However, any concerns prior to that time should be reported to the doctor’s office.