pt post cardiac cath

Published

Hello~

I recently was taking care of a pt in the cardiac progressive care unit who came in with syncope and atrial-fib. A heart cath was later performed that day and results showed blockage of all 3 arch vessels so a CABG was scheduled later in the week. I have come up with a list of nursing diagnoses for this patient but am having trouble writing out my care plan for the top three. So far I have my first two written (decreased cardiac output and altered cardiopulmonary tissue perfusion). Pain was also a focus this day as she was having much pain in her lower back (but not relating to her dx). I think risk for infection should be one of the top priorities b/c of her wound assessment post heart cath (she also has an elevated WBC count). She also is at risk for bleeding.. can't really be used as a nursing diagnosis though..?!? Anxiety and activity intolerace were some other dx I addressed this day. I just can't seem to pick my last top diagnosis! Any thoughts/advice??! :confused:

THANKS :wink2:,

confused & concerned nursing student

Up Vote Up Vote ×
Specializes in Cardiac Telemetry, ED.

Did she have an MI? Most people have elevated WBCs after an MI, due to the inflammatory process in the myocardium. That does not indicate infection.

Decreased CO would be appropriate, but decreased cardiopulmonary tissue perfusion I'm not so sure about. As far as her wound, I'd say risk for bleeding would be more a more immediate concern than R/F infection.

Up Vote Up Vote ×
Specializes in med/surg, telemetry, IV therapy, mgmt.

decreased cardiac output should be your primary diagnosis for this patient. that diagnosis is specific for poor perfusion in the heart only. poor perfusion in the heart results in electrical disturbances (cardiac arrhythmias) which are among the defining characteristics of this diagnosis ([color=#3366ff]decreased cardiac output). ineffective tissue perfusion, cardiopulmonary refers to combined dyspnea and chest pain as a result of problems with perfusion to the lungs and heart together with messed up abgs.

Up Vote Up Vote ×
Specializes in Corrections, Cardiac, Hospice.

How about Lack of Knowledge regarding procedure. Your assessment can include what she does or doesn't know about open heart and the plan of care can include teaching regarding sternal precautions, post op rehab and respiratory care post op.

Up Vote Up Vote ×

I agree with decrease cardiac output.

Up Vote Up Vote ×
+ Join the Discussion