patient with stent placement what assessment finding requires immediate report

Clinical history taking and physical examination, including an assessment of cardiovascular risk factors and of potential evidence of myocardial ischemia, constitute the best way to detect possible progression of coronary heart disease. Diagnostic coronary angiography is not routinely indicated after coronary stent implantation.

Full Answer

What is a stent placement?

What is a stent placement? A stent is a wire mesh stainless steel tube that holds an artery open and keeps it from closing again. It becomes a permanent part of your artery. Why is it necessary? Fatty deposits can block blood flow through arteries and cause pain.

How do I know if my stent is working properly?

Depending on the stent used, patients may have to be monitored to ensure the stent is working properly and is in the right place. Airway stents may be checked through bronchoscopy several weeks after the procedure; a chest X-ray or CT scan could also be used.

What happens to patients who undergo stent placement following a heart attack?

Patients who undergo stent placement following a heart attack may have a different recovery. Their hospital length of stay and return to activities will likely be longer. During the recovery period, patients should seek medical attention if they experience any of the following:

What can I do to prepare for a stent placement?

For some patients, their doctor may also recommend lifestyle changes. This could include exercise, quitting smoking, and following a healthy diet. Patients who undergo stent placement following a heart attack may have a different recovery. Their hospital length of stay and return to activities will likely be longer.

What should I watch after stent placement?

Increased pain, redness, swelling, bleeding, or other drainage from the insertion site. Coolness, numbness or tingling, or other changes in the affected arm or leg. Chest pain or pressure, nausea or vomiting, profuse sweating, dizziness, or fainting.

What should I assess after PCI?

Monitor the patient's 12-lead ECG for changes, and be alert for chest discomfort or pain, which may indicate in-stent restenosis. Also monitor for reperfusion injury (characterized by chest discomfort, pain, or arrhythmias such as premature ventricular contractions) and coronary artery spasm, which could cause angina.

What should be assessed first after cardiac catheterization?

Identify access site (position and whether arterial or venous). Check if the patient has been on anticoagulation. Enquire about the findings of the catheter procedure. Ascertain what medications have been administered or ordered.

What is the priority assessment in patients before angiography?

Before your angiogram procedure starts, your health care team will review your medical history, including allergies and medications you take. The team may perform a physical exam and check your vital signs — blood pressure and pulse.

Which nursing assessment is most important immediately following cardiac catheterization?

The most important nursing action following cardiac catheterization is assessing the groin for bleeding and the leg for color, warmth (circulation) and pulse. Postcatheterization care involves monitoring vital signs every 15 minutes for an hour, then every 30 minutes for an hour or until stable.

What should you monitor after angioplasty?

A nurse will monitor your vital signs, the insertion site, and circulation/sensation in the affected leg or arm. You should immediately inform your nurse if you feel any chest pain or tightness, or any other pain, as well as any feelings of warmth, bleeding, or pain at the insertion site in your leg or arm.

What should the nurse monitor after cardiac catheterization?

A nurse will monitor vital signs, the insertion site, and circulation/sensation in the affected leg or arm. The plastic sheath which was inserted in the patient's groin, neck, or arm will be removed soon after unless the patient requires specialised blood thinning medication.

What is most important to do for a patient after cardiac catheterization?

You can expect to feel tired and weak the day after the procedure. Take walks around your house and plan to rest during the day. Do not strain during bowel movements for the first 3 to 4 days after the procedure to prevent bleeding from the catheter insertion site.

What is the most common complication of cardiac catheterization?

Hematoma/Retroperitoneal Bleeding These are among the most common complications seen after cardiac catheterization procedures. Hematomas are usually formed following poorly controlled hemostasis post sheath removal.

What are your nursing responsibilities when a patient is undergoing angiography?

While the patient is in the observation area, nurses check vital signs, the incision site, and attend to all of the patient's needs. It is necessary for the patient to lie still with his or her head flat for six to eight hours.

Which complication of cardiac catheterization should the nurse monitor?

Perforation of heart or vessels. Stroke or death. Hematoma.

What is the role of the nurse before and after the cardiac catheterization?

A cardiac cath lab nurse is a Registered Nurse who specializes in assisting with catheterizations. They monitor and examine patients prior to procedures, as well as during and after. They also administer medications and assist the medical team in whatever they may need during the procedure.

What should I do after an angioplasty?

To keep your heart healthy after angioplasty, you should:Quit smoking.Lower your cholesterol levels.Eat a healthy diet that is low in saturated fat.Maintain a healthy weight.Control other conditions, such as diabetes and high blood pressure.Get regular exercise.Take medications as prescribed by your doctor.

What are the complications of cardiac catheterization?

What are the risks of cardiac catheterization?Bleeding or bruising where the catheter is put into the body (the groin, arm, neck, or wrist)Pain where the catheter is put into the body.Blood clot or damage to the blood vessel that the catheter is put into.Infection where the catheter is put into the body.More items...

What is post PCI care?

After a PCI, the patient should be followed up both by the primary care physician and by the cardiologist one week after the procedure, and then every three to six months for the first year.

Is ST elevation normal post PCI?

Background. In the thrombolytic era, persistence of ST‐segment elevation was considered a marker of left ventricular (LV) aneurysm. ST‐segment elevation may still be found persistently raised after successful primary percutaneous coronary intervention (PCI).

What is a stent in a stent?

A stent is a wire mesh stainless steel tube that holds an artery open and keeps it from closing again. It becomes a permanent part of your artery.

How long does a balloon stay in the artery after a stent?

This will go away when the balloon is deflated. A small tube called a sheath may stay in the artery for two to four hours after the procedure.

How does a doctor move a balloon catheter?

The doctor moves a balloon catheter, and then a stent, to the site of the blockage. The balloon is inflated and stretched wide against the artery walls, which opens the blockage. Then the balloon is deflated and taken out, leaving the stent in place.

Can a stent cause a heart attack?

A piece may break off, form a clot, and cause a heart attack or stroke. A stent opens the blockage and keeps it open, which allows blood to flow smoothly. Good blood flow reduces pain and risks of clots forming.

How often should a patient follow up after a stent implantation?

As recommended in the German National Disease Management Guidelines, patients with CHD and those who have undergone stent implantation should be followed up regularly (every 3 to 6 months) by their primary care physicians.

What should be assessed in a patient's tobacco use?

The patient’s tobacco use, physical activity, nutrition, and regular taking of medications should be assessed, and, if necessary, the patient should be encouraged to change his or her behavior in health-promoting ways (recommendation grade A, evidence level 1).

How often should a patient be followed up after a PCI?

After a PCI, the patient should be followed up both by the primary care physician and by the cardiologist one week after the procedure, and then every three to six months for the first year. Clinical history taking and physical examination, including an assessment of cardiovascular risk factors and of potential evidence of myocardial ischemia, ...

What is stress ECG?

A stress test (stress ECG) is indicated for patients who have undergone PCI if their symptoms and signs have changed and/or if there is clinical suspicion that their CHD may have become worse ([6], recommendation grade A, evidence level 1).

Stent placement procedure

Typically, you’re awake during your stent placement because it’s a minimally invasive procedure. Medicine helps you relax, and a local anesthetic numbs the area of insertion, but you’re able to hear your doctor and you’re aware of what’s going on around you.

After stent placement

After stent placement, you need to rest in bed for up to 24 hours, so expect to stay overnight at the hospital. This ensures that your medical team can monitor you and that you don’t experience any complications. If you had a heart attack or stroke before the stent placement, you may need to stay in the hospital for a while longer.

Keep your arteries healthy after stent placement

After a stent placement procedure, you want to make any necessary lifestyle changes to help prevent another artery from becoming blocked. Some of the steps you can take include:

What can be done about the vast numbers who don’t attend post-care after stent placement?

What can be done about the vast numbers who don’t attend post-care after stent placement? One thing we already know from the Michigan study is that simply getting physicians on board with recommending rehabilitation works. Previously, some studies have shown that physician referrals to cardiac rehabilitation were as low as twenty percent.

What is the role of a patient after a stent placement?

Patient care after stent placement plays a critical role, both in their recovery and in preventing further issues. However, recent studies have found that many patients aren’t getting the care that they need post-placement. Just one in three patients enroll in recommended cardiac rehabilitation after their stent placement, ...

How many people enroll in cardiac rehabilitation after stent placement?

Just one in three patients enroll in recommended cardiac rehabilitation after their stent placement, according to a Michigan study reported in the Journal of the American College of Cardiology. And yet, accessing aftercare may be one of the best things a patient can do to improve their health:

Why are patients more likely to attend the Michigan study?

No “acute” reason for attendance: Patients in the Michigan study were more likely to attend if they had an acute condition that led to the stent, whereas patients with conditions such as diabetes or peripheral artery disease were less likely to attend.

What is a stent made of?

The goal of using a stent is to keep the artery open overtime. Typically, stents are made of a metal mesh material , but they are sometimes made of fabric;

What to do after a heart attack with a stent?

For some patients, their doctor may also recommend lifestyle changes. This could include exercise, quitting smoking, and following a healthy diet. Patients who undergo stent placement following a heart attack may have a different recovery. Their hospital length of stay and return to activities will likely be longer.

What are the symptoms of a catheter insertion?

During the recovery period, patients should seek medical attention if they experience any of the following: Bleeding, swelling, pain, or discomfort at the catheter insertion site. Redness, swelling, drainage, or fever indicative of infection.

How long after catheter insertion can you have a stress test?

A stress test may also be performed several weeks after the procedure, which will help the doctor determine appropriate activity and exercise recommendations.

What are the symptoms of a syringe?

During the recovery period, patients should seek medical attention if they experience any of the following: 1 Bleeding, swelling, pain, or discomfort at the catheter insertion site 2 Redness, swelling, drainage, or fever indicative of infection 3 Changes in temperature or color in arm or leg where the procedure was performed 4 Faintness or weakness 5 Chest pain 6 Shortness of breath

Does BMS or DES have a significant difference in outcomes?

Evidence does not suggest significant differences in outcomes whether patients receive DES or BMS. A 2016 study published in the New England Journal of Medicine assessed the composite outcome of death from any cause and nonfatal spontaneous myocardial infarction based on stent type.

What Is A Stent Placement?

Why Is It Necessary?

How Is It done?

What Should You Expect?

During The Procedure

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After The Procedure