Discharge teaching post cath

Miami NightNurse · Feb 7, 2008

They can not submerge the access site for atleast 5 days-No Bath, no swimming. I'm a diabetic so when I had mine I waited 2 weeks before I submerged it. They also can not lift over 5 lbs for 6 weeks. And of course tell them to report any reddness, swelling or drainage immediately

jordangregory · Feb 7, 2008

What is the deal with not being able to submerge it?

Medic2RN, BSN, RN, EMT-P · Feb 7, 2008

In addition to the above, I've been told by different cardiologists to stress the importance of taking their Plavix. I was instructed to tell a couple of patients to point blank tell them if they did not take their Plavix then they would die.

I hopefully got that point through to them.

Editorial Team / Admin · Feb 8, 2008

What is the deal with not being able to submerge it?

As I tell our post-cath pts, "there is still a hole from the inside of your body to the outside, where we put the tube, and you need to wait one week before taking a bath, jacuzzi, swimming or otherwise sitting in water, to prevent germs from entering through the hole."

Miami NightNurse · Feb 8, 2008

Plavix is generally given after a stent placement. I just had a stent placed and my blood is so thinned out I coughed hard and my eyeball was bloodshot for days but I still have to take the Plavix or I could get re in stent stenosis and suffer another MI and circle the drain

sharona97, BSN, RN · Feb 8, 2008

I agree with all the above posts. But I also include change of lifestyle. No salt. Start looking at the mg's per serving. This seems to be the most difficut to get through, becuse they are feeling better. There nitro is gone now (or should be if stented or CABG).

I suggest heart healthy classes offered through the hospital and to involve their partner or spouse.

It's really great when you get the feedback that "I learned to make saltless bread", and more.

I also explain the outpatient cardiac post-op plan but not everyone jumps on that boat.

shmoofins · Feb 9, 2008

Stress that if they smoke, they should definitely quit! Also like others said reinforce Plavix big time if they've gotten stents.

harley007 · Feb 9, 2008

We also do the no bath for a week and really stress the need for no further smoking. Even though they may have a bit of Versed/Fentanyl on board we all - attending MD/Fellow MD/RN repeat the same immediate teaching of post 4 hours no leg moving affected side, lifting of head, gentle pressure applied to groin if coughing or sneezing. If drug eluding stent inserted - the severe Plavix lecture is given by all of us and repeated before discharge on our post cath. unit. Under no circumstances stop taking Plavix even if you are having surgery/dental work unless the cardiologist okays it. I also inform them of the financial assistance programs available if you cannot afford the drug, if you go on vacation and forget the medication CALL YOUR MD etc., etc. as we have had patients do any number of these things and ended up with repeat problems. It makes me crazy when they are back on our table as an acute case, in intense chest pain, having called us into the lab in the middle of the night and the tell us nobody ever told them about the need for taking Plavix. Best of all you know they were told as you were the one of the people that that told them!