Post Heart Catheterization Treatment Essay

However, there are additional guidelines in terms of assessing the patient for prolonged catheter use. There should be frequent assessment and evaluation of the patient’s need for continued use. It is important to note that in addition to determining the patient’s need for catheterization, prior to insertion the nurse should also complete the following:

It can also occur during blood transfusion or during dressing change. The insertion of central catheters can occur in the Interventional Radiology or sometimes at the bedside. Regardless of the where the insertion process occur, a sterile field must always be maintained and sterile techniques must always be employed to prevent any organisms from being introduced to the central line into the patient. According to The Joint Commission (2013), many organizations such as Michigan Keystone Intensive Care Unit Project and Institute for Healthcare Improvement are actually adhering to insertion bundles to reduce the CLABSI rates. The bundles include hand hygiene, maximal barrier precautions, chlorhexidine skin preparation, avoidance of femoral vein, and prompt removal of central catheter. Furuya et al. (2011) studied the effectiveness of the insertion bundle and how it impacts the bloodstream infections for patients in the Intensive Care Unit. As a result, lesser infection have occurred when the compliance is high. As mentioned, the site of the catheter also needs to be considered in the insertion process. Avoiding areas such as the groin to access the femoral artery is recommended because this area can be easily contaminated with urine or feces. In addition, after the insertion of a new central line, all the used IV tubing

Only when it is absolutely necessary should a catheter be inserted into a patient. Every patient is assessed for the need for a Foley catheter. If the Foley is inserted, assessments are also then done daily to see if the need is still valid. If the reason is not justifiable the catheter must be removed from the patient (Joint Commission releases new NPSG for CAUTI, 2011). Nurses must follow guidelines while inserting indwelling catheters as well. Aseptic technique is critical to maintain during this process. The use of sterile equipment and a sterile procedure helps to reduce the risk of CAUTI. If in any way the catheter becomes contaminated during the process of insertion, the nurse should discard of the entire catheter and start with a new, sterile kit. Proper hand hygiene is very important before and after contact with indwelling catheters to decrease risk of infection. Maintenance of a close drainage is system is also important that way bacteria are not able to get in and cause infection (Revello & Gallo, 2013). Decreasing the number of times Foleys are inserted and how long they stay in for can help reduce the risk of CAUTI since the longer a Foley stays in, the higher the risk of infection becomes. Nurses must keep the catheter line patent, with no kinks to allow urine to flow freely through into the collection bag. When a urine sample must be obtained it must be done in a sterile

J to prevent hospital acquired pressure ulcers. Frequent turning, repositioning, meticulous skin care and assessment are appropriate steps that would be taken to prevent pressure ulcers.

The patient will require surgery to repair the hole in the intestines, and subsequently will have a drainage tube, NG tube, and feeding tube. All drains will need to monitored for placement/movement, and drainage. Input and output will be closely monitored and recorded. The patient will remain on NPO, or nothing by mouth, to rest the bowels along with frequent assessments to monitor for infection and bleeding. The nurse will need to monitor for bowel sounds, vital sign changes, temperature changes, pain, abdomen girth, and wound/incision inspections. The following labs will require monitoring: CBC, H&H, albumin, BUN & creatinine, glucose, and ABG’s and lactic acid if sepsis is suspected. Careful and frequent monitoring of labs will alert the nurse if the patient develops sepsis, or hypovolemia due to excessive bleeding (Belinhof, et al., 2012). In addition to vital signs and labs, the nurse will also include patient assessment into consideration before drawing conclusions by means of critical thinking. After the full assessment has been made, the nurse will report any findings to the health care provider that require further investigation or

According to Clyman, “I put my needle sticking it through and through over and over laying the lacerated parts together as nice as I could with my hands.”

Ask the patient to lay on their back. The patient's legs should be spread and their feet should be together. The patient laying on their back relaxes the bladder and urethra, making easier to insert the catheter.  You can even assist the patient getting into the supine position.

an artery in the neck. Once the catheter is in place, the needle is removed and a

• Dispose of a multiple use catheter when it becomes dry, brittle, or cloudy. This usually happens after you use the catheter for 1 week.

Medical staff will clean and shave your groin or arm for the insertion of the catheter. A local numbing agent will be administered, but you will be awake during the procedure. Medicines for anxiety could be given if patient is having trouble relaxing during the exam. Next, a small catheter will be inserted into an artery. The doctor then uses x-rays to guide the catheter to the area of interest. Once the catheter is in place, dye will be inserted through tube. This allows for visualization of your blood vessels. Very minimal movement will be aloud during this exam to ensure safety and high quality images. This procedure could last one to two hours. If this is a planned procedure and not an emergency, this is normally only scheduled in the

Nurses should also inspect the heels of a patient carefully. If a patient is using a medical device, it is crucial to provide effective and safe teaching about rotating and repositioning the medical device (EPUAP, NPUAP, & PPPIA, 2014). The medical device must be the correct size and fit for the patient so that the degree of pressure or possible damage to the skin is decreased (EPUAP, NPUAP, & PPPIA, 2014). This will help in preventing medical device related pressure ulcers.

Cardiac surgery with cardiopulmonary bypass (CPB) is one of the most widely recognized major surgical procedures worldwide. Renal failure is a noteworthy cause of morbidity and mortality after cardiac surgery.1,2 Acute kidney injury (AKI) occurs in about 20-40% of patients3 and is associated with a mortality rate of 8% compared with 0.9% in patients without AKI. AKI requiring hemodialysis in the postoperative period is uncommon (~ 1% to 5%), yet associated with a remarkably high mortality rate of 30% to 60%.4 (11–13). AKI increases the risk for ensuing chronic kidney disease and kidney failure, with its associated morbidity and mortality.5

This Friday at the Cardiac Catheterization Lab was a very productive and eventful one. First thing in the morning I went to watch a procedure, or “case” as they call it that the hospital since there were not any patient files ready to be filed away. When I went to go to the control room with the surgery happening, the patient was already on the surgery bed and the nurses and tech people (I do not know their professional name or title) were preparing the equipment that they needed to perform the surgery. Also, when I walked in I saw one of the traveling tech people that I met a few weeks ago and he said hi to me and explained that he was helping the doctor with the same type of procedure that I watched with him on the first day I met him.

To perform a cardiac catheterization the cardiologist will insert a sheath, or a short tube usually into the femoral artery. A long very thin catheter will then be fed through the sheath and guided through the arteries until it is in the heart and coronary arteries. The physician uses fluoroscopy equipment to guide the catheter into the coronary arteries. To allow for clear viewing of the coronary arteries, contrast material is injected into the catheter. As the contrast material flows through the heart chambers and coronary arteries x-rays are taken. The

The part of the skin where the needle was inserted will be covered with a bandage (dressing).