am i correct on this coronary angiogram question?

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if you were caring for mr meyer immediately post coronary angiogram, you would:

1. assess pt vitals signs, neurovascular obs on both legs, palpate femoral artery assessing for haematoma development, continuous cardiac monitoring, administer pain relief, position the patient in semi- recumberent position to facilitate breathing as he has had a general anaesthetic[jc1] .

2. assess pt vitals signs, neurovascular obs on both legs, position the patient supine, assess for bleeding from the femoral artery and ensure adequate fluid intake to facilitate excretion of dye.

3. assess pt vitals signs, neurovascular obs on leg of the femoral artery[jc2] used to insert pulmonary arterial catheter[jc3] , position the patient in supine position and assess for bleeding from the femoral artery.

4. assess pt vitals signs, neurovascular obs on both legs, position the patient supine, assess for bleeding from the femoral vein[jc4] , ensure adequate fluid intake to facilitate excretion of dye, continuous cardiac monitoring and administer pain relief prn.

[jc1]usually not require

[jc2]pulmonary arterial catheter insert into the femoral vein

[jc3]its purpose is diagnostic; it is used to detect heart failure or sepsis, monitor therapy, and evaluate the effects of drugs.

[jc4]femoral artery

this is a very tricky i am choosing number 2 as my answer am i correct?

My guess is #4. When they return from the cath lab you will be checking pedal pulses, assessing the site for any kind of bleeds and vitals, they will be on cardiac monitoring, they have to lie flat with leg straight for 4-6 hours (depending if it's diagnostic versus stent, etc.), will need the fluids and pain med prn.

goodstudentnowRN

1,007 Posts

Specializes in Telemetry.

I would chose number 4 too. It makes more sense to me.

Specializes in Ortho, Neuro, Detox, Tele.

Ok, you must approach the question using the NCLEX hospital thought...in the perfect world. 1 can be elimanated right away as the patient must be supine.....3 can be eliminated because you don't have any mention of fluid or pain and you are only observing one leg....2 can be elimanated because there is no mention of cardiac monitoring....4 is left as the correct answer.

Daytonite, BSN, RN

1 Article; 14,603 Posts

Specializes in med/surg, telemetry, IV therapy, mgmt.

if you were caring for mr meyer immediately post coronary angiogram, you would:

1. assess pt vitals signs, neurovascular obs on both legs, palpate femoral artery assessing for haematoma development,
continuous cardiac monitoring
, administer pain relief, position the patient in semi-recumberent position to facilitate breathing as he has had a general anaesthetic.

2. assess pt vitals signs, neurovascular obs on both legs, position the patient supine, assess for bleeding from the femoral artery and ensure adequate fluid intake to facilitate excretion of dye.

3. assess pt vitals signs, neurovascular obs on leg of the femoral artery used to insert pulmonary arterial catheter, position the patient in supine position and assess for bleeding from the femoral artery.

4. assess pt vitals signs, neurovascular obs on both legs, position the patient supine, assess for bleeding from the femoral vein, ensure adequate fluid intake to facilitate excretion of dye,
continuous cardiac monitoring
and administer pain relief prn.

#3 is wrong because it is not the best answer. these patients are always placed on continuous ekg monitoring because their coronary vessels were entered with a foreign object and a coronary spasm can occur at any time after the procedure bringing on an arrhythmia. the procedure is done to detect vessel occlusion which is the underlying cause of many arrhythmias, so continuous ekg monitoring is necessary. because a femoral blood vessel was punctured and heparin may have been given, the puncture site and the legs need to be observed, assessed and the patient needs to stay supine. pain relief is provided for if the patient experiences discomfort from the femoral puncture or experiences chest pain.

Specializes in MSN, FNP-BC.

My guess is also #4.

jchan0425

13 Posts

assess for bleeding from the femoral vein

isn't the procedure perform on a femoral artery?

KAYBDT6, BSN, RN

1,602 Posts

Specializes in L & D, Med-Surge, Dialysis.

Agree with option #4 because after the procedure, the pt must be on cardiac monitoring and fluid must be offered to excrete the contrast dye used prior to the procedure. Also the femoral vein must be assess for bleeding and pain medication must be given to relieve pain.

morte, LPN, LVN

7,015 Posts

assess for bleeding from the femoral vein

isn't the procedure perform on a femoral artery?

i looked it up, yup, an artery.....so #2 would seem correct.....just not complete....but are they ever?

jchan0425

13 Posts

that's why i am struggling

KAYBDT6, BSN, RN

1,602 Posts

Specializes in L & D, Med-Surge, Dialysis.
i looked it up, yup, an artery.....so #2 would seem correct.....just not complete....but are they ever?
:down::down:

This is how question is being asked on NCLEX Exam, every option seems right but the option #2 said assessment and fluid intake to help in excretion of the dye. But option #4 said assess the femoral vein for bleeding, offer fluid to excrete the dye,place pt on cardiac monitor to detect irregular dysrrthymia and offer the pt pain mediation to relief post- op pain.

#4 is complete intervention while option #2 is an incomplete intervention.:up::up:

#1 DISTRACTOR:down:

#2 INCOMPLETE:nono:

#3 DISTRACTOR:down:

#4 COMPLETE:up::yeah::up:

morte, LPN, LVN

7,015 Posts

:down::down:

This is how question is being asked on NCLEX Exam, every option seems right but the option #2 said assessment and fluid intake to help in excretion of the dye. But option #4 said assess the femoral vein for bleeding, offer fluid to excrete the dye,place pt on cardiac monitor to detect irregular dysrrthymia and offer the pt pain mediation to relief post- op pain.

#4 is complete intervention while option #2 is an incomplete intervention.:up::up:

#1 DISTRACTOR:down:

#2 INCOMPLETE:nono:

#3 DISTRACTOR:down:

#4 COMPLETE:up::yeah::up:

BUT, #4 says to assess vein, when it was an artery that was punctured....!!

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