Cardiovascular Angiography

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Outline

Overview

  1. Cardiovascular angiography
    1. Contrast into arteries
    2. X-ray
    3. View coronary arteries and heart

Nursing Points

General

  1. Procedure
    1. Catheter inserted into upper leg/groin artery
    2. Threaded up to vessels supplying heart
    3. Contrast dye inserted
    4. X-ray to view vessels
    5. Doctor may intervene as needed (stents to open arteries)
  2. Purpose
    1. View blood vessels supplying heart
    2. Diagnose disease
      1. Valves
      2. Coronary arteries
      3. Blood flow
      4. Blockage
  3. Indications
    1. Chest pain
    2. Heart disease
    3. Valve issues
    4. Heart defects

Assessment

  1. Before
    1. NPO 6-8 hours prior
    2. Ask patient if allergic to contrast
    3. Doctor may hold anticoagulants
    4. Consent signed

Therapeutic Management

  1. During
    1. Clean and shave upper leg/groin area
    2. Sedative through IV (nurse or radiology tech)
    3. Doctor places and threads catheter through leg artery
    4. Monitor vital signs
  2. After
    1. Doctor removes catheter
    2. Apply pressure 10-15 minutes (closing device if needed)
    3. Keep patient flat for 2 hours to prevent bleeding
    4. Keep leg straight for up to 6 hours
    5. Assess for bleeding

Nursing Concepts

  1. Safety -> Radiation
  2. Perfusion -> Coronary arteries and heart
  3. Patient educaton -> Educate on procedure and after

Patient Education

  1. Doctor order when to restart anticoagulants
  2. Okay to resume activity next day
  3. Call doctor if any redness or pain at injection site in leg

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Transcript

Hey guys! Welcome to the lesson on cardiovascular angiography. 

During the cardiovascular angiography the doctor inserts a catheter into the inner-upper leg near the groin and threaded to the vessels supplying the heart. Contrast dye is inserted into the catheter and an X-ray is used to view the vessels. Intervention is provided by the doctor as needed like stent placement to open the arteries. Let’s discuss the purpose of this test.

The procedure helps to view the blood vessels supplying the heart to diagnose disease in the coronary arteries or the valves. The doctor will be able to see any obstructions or blockage to the blood flow that may cause a myocardial infarction. Here’s a picture from a cardiovascular angiography showing blockage here and here. Let’s discuss why this test is done. 

The doctor may choose to order this test if the patient has chest pain, heart disease like coronary artery disease, valve issues, or heart defects. Let’s talk about what to do before the procedure. 

Before the procedure, the patient will be kept NPO meaning no food or drink for 6-8 hours. Ask the patient if they have any allergies to contrast because if they do they may not be able to have the test. If the patient is on anticoagulants, ask the doctor if they want the medication held and for how long before the procedure to prevent bleeding. Explain the procedure and have the consent signed by the patient. The consent may be done right before the procedure so the doctor may explain any risks.

During the procedure, you will clean and shave the site on the upper-inner leg near the groin. You will provide an IV sedative to relax the patient before the doctor places and threads the catheter to use for the contrast. You will monitor the vital signs for any deviations from normal while the catheter is in the main arteries. 

After the procedure the doctor will remove the catheter and you will hold pressure for 10-15 minutes. A closing device may be used. Keep the patient flat for 2 hours and keep the leg straight for 6 hours. Assess the site for bleeding, and hold pressure if it does. Next let’s talk about patient education. 

Let the patient know when they are able to restart anticoagulants per doctor order after the procedure. They may resume their normal activities the next day. Tell them to let you know if they notice any red or pain at the injection site. 

The priority nursing concepts for the patient with a cardiovascular angiography are safety, perfusion, and patient education. 

Alright guys, let’s review the key points. The cardiovascular angiography is done to view the heart vessels using contrast and an X-ray to diagnose defects and blockages. Before the scan, the patient will be NPO, you will explain the procedure and have them sign the consent, and ask the doctor about holding the anticoagulants to avoid bleeding. During the procedure you will clean and shave the injection site on the upper inner thigh and groin. You will administer the IV sedative to relax the patient and monitor vital signs during the procedure. After it’s over, you will hold pressure for at least 10 minutes and may use a closing device. The patient needs to stay flat for 2 hours and keep their leg straight for 6 hours to prevent bleeding. Let the patient know when they can restart the anticoagulants and to keep an eye on the injection site for redness or pain. 

Alright guys, that’s it on the cardiovascular angiography! No go out and be your best self today, and as always, happy nursing!


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Study Plan Lessons

Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
EKG (ECG) Course Introduction
ABGs Nursing Normal Lab Values
Care of the Pediatric Patient
Coronary Artery Disease Concept Map
Electrical A&P of the Heart
Respiratory A&P Module Intro
ABG (Arterial Blood Gas) Interpretation-The Basics
Computed Tomography (CT)
COPD Concept Map
Electrolytes Involved in Cardiac (Heart) Conduction
Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging (MRI)
Nursing Care and Pathophysiology for Sickle Cell Anemia
Adult Vital Signs (VS)
CT & MR Angiography
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nasal Disorders
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Pediatric Vital Signs (VS)
Respiratory Acidosis (interpretation and nursing interventions)
Thrombocytopenia
Cardiovascular Angiography
Preload and Afterload
Respiratory Alkalosis
Congestive Heart Failure Concept Map
Echocardiogram (Cardiac Echo)
Performing Cardiac (Heart) Monitoring
Hypertension (HTN) Concept Map
Pulmonary Function Test
Electroencephalography (EEG)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Asthma
02.02 Cardiomyopathy for CCRN Review
Leukemia
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Respiratory Terminology
Oncology Important Points
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Lung Cancer
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Heart (Cardiac) and Great Vessels Assessment
Intracranial Pressure ICP
Nursing Care and Pathophysiology for Pulmonary Edema
Cerebral Perfusion Pressure CPP
Cerebral Perfusion Pressure CPP
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.12 Myocardial Infarction- Inferior Wall for CCRN Review
Grief and Loss
Dementia and Alzheimers
Acute Coronary Syndrome (ACS)
Immunology Module Intro
Respiratory Infections Module Intro
Sickle Cell Anemia
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Aneurysm & Dissection
Nursing Care and Pathophysiology for Heart Failure (CHF)
Hemoglobin (Hbg) Lab Values
Iron Deficiency Anemia
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Cardiopulmonary Arrest
Hematocrit (Hct) Lab Values
Nursing Care and Pathophysiology for Anaphylaxis
Sinus Tachycardia
Meds for Alzheimers
Pacemakers
White Blood Cell (WBC) Lab Values
Heart (Heart) Failure Exacerbation
Platelets (PLT) Lab Values
Coagulation Studies (PT, PTT, INR)
Hypertensive Emergency
Supraventricular Tachycardia (SVT)
Fibromyalgia
Migraines
Tension and Cluster Headaches
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
Cholesterol (Chol) Lab Values
Nursing Care and Pathophysiology of Hypertension (HTN)
Leukemia
Pulmonary Embolism
Acute Respiratory Distress
Cardiac (Heart) Disease in Pregnancy
Nursing Care and Pathophysiology for Cardiomyopathy
Respiratory Structure & Function
ACLS (Advanced cardiac life support) Drugs
Fever
Respiratory Trauma Module Intro
Seizure Causes (Epilepsy, Generalized)
Increased Intracranial Pressure
Nursing Care and Pathophysiology for Pulmonary Embolism
Anti-Platelet Aggregate
Respiratory Procedures Module Intro
Electrical Activity in the Heart
Nursing Care and Pathophysiology for Meningitis
Respiratory Terminology
Thrombin Inhibitors
Thrombolytics
Blood Plasma
Patient Positioning
Acute Otitis Media (AOM)
07.06 Increased Intracranial Pressure (ICP) for CCRN Review
Dystocia
Acute Bronchitis
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Asthma
Asthma
Cystic Fibrosis (CF)
Congenital Heart Defects (CHD)
Congenital Heart Defects (CHD)
Respiratory Structure & Function
Defects of Increased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Obstructive Heart (Cardiac) Defects
Obstructive Heart (Cardiac) Defects
Respiratory Functions of Blood
Mixed (Cardiac) Heart Defects
10.01 Arterial Blood Gas (ABG) Interpretation for CCRN Review
Hierarchy of O2 Delivery
Histamine 1 Receptor Blockers
10.03 Acute Respiratory Failure for CCRN Review
Airway Suctioning
Cerebral Palsy (CP)
Sympatholytics (Alpha & Beta Blockers)
ACE (angiotensin-converting enzyme) Inhibitors
Angiotensin Receptor Blockers
Calcium Channel Blockers
Calcium Channel Blockers
Cardiac Glycosides
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Parasympathomimetics (Cholinergics) Nursing Considerations
Bronchodilators
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Corticosteroids
Corticosteroids
Nitro Compounds
Anticonvulsants
Sympatholytics (Alpha & Beta Blockers)
Bronchodilators
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Acute Coronary Syndrome for Certified Emergency Nursing (CEN)
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Acute Otitis Media (AOM)
Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)
AIDS Case Study (45 min)
Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Anaphylaxis Nursing Interventions for Certified Perioperative Nurse (CNOR)
Anemia for Progressive Care Certified Nurse (PCCN)
Nursing Care and Pathophysiology for Anemia
Aneurysm (Dissecting, Repair) for Progressive Care Certified Nurse (PCCN)
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)
Asthma for Certified Emergency Nursing (CEN)
Asthma (Severe) for Progressive Care Certified Nurse (PCCN)
Asthma Concept Map
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Bicarbonate (HCO3) Lab Values
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Carbon Dioxide (Co2) Lab Values
Cardiac (Heart) Enzymes
Cardiac Anatomy
Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Cardiovascular Trauma for Certified Emergency Nursing (CEN)
Cerebral Palsy (CP)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Chronic Obstructive Pulmonary Disease (COPD) for Certified Emergency Nursing (CEN)
Chronic Obstructive Pulmonary Disease (COPD) Case Study (60 min)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Congestive Heart Failure (CHF) Labs
Congestive Heart Failure Concept Map
COPD (Chronic Obstructive Pulmonary Disease) Labs
COPD Concept Map
COPD Exacerbation for Progressive Care Certified Nurse (PCCN)
COPD management Nursing Mnemonic (COPD)
Coronary Artery Disease Concept Map
Cystic Fibrosis (CF)
Dementia Nursing Mnemonic (DEMENTIA)
Diagnostic Criteria for Lupus Nursing Mnemonic (SOAP BRAIN MD)
EKG Basics – Live Tutoring Archive
Furosemide (Lasix) Nursing Considerations
Head and Spinal Cord Trauma for Certified Emergency Nursing (CEN)
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart Failure for Certified Emergency Nursing (CEN)
Heart Failure 2 – Live Tutoring Archive
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Failure Case Study (45 min)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Hematocrit (Hct) Lab Values
Hematologic Disorders for Certified Emergency Nursing (CEN)
Hemoglobin (Hbg) Lab Values
Hypertension for Certified Emergency Nursing (CEN)
Hypertension (HTN) Concept Map
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertensive Crisis Case Study (45 min)
Increased Intracranial Pressure (ICP) for Certified Emergency Nursing (CEN)
Intracranial Pressure ICP
Leukemia
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Leukemia Case Study (60 min)
Lymphoma
Management of Lyme Disease Nursing Mnemonic (BAR)
MI Surgical Intervention
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Myocardial Infarction (MI) Case Study (45 min)
Noncardiac Pulmonary Edema for Certified Emergency Nursing (CEN)
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Lyme Disease
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Activity Intolerance
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Acute Pain
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Alzheimer’s Disease
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Aortic Aneurysm
Nursing Care Plan (NCP) for Arterial Disorders
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Bronchoscopy (Procedure)
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Cellulitis
Nursing Care Plan (NCP) for Cerebral Palsy (CP)
Nursing Care Plan (NCP) for Chronic Obstructive Pulmonary Disease (COPD)
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Cystic Fibrosis
Nursing Care Plan (NCP) for Decreased Cardiac Output
Nursing Care Plan (NCP) for Dementia
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Emphysema
Nursing Care Plan (NCP) for Guillain-Barre
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) for Hypertension (HTN)
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Lung Cancer
Nursing Care Plan (NCP) for Lyme Disease
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Nursing Care Plan (NCP) for Migraines
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Otitis Media / Acute Otitis Media (AOM)
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Pulmonary Embolism
Nursing Care Plan (NCP) for Respiratory Failure
Nursing Care Plan (NCP) for Restrictive Lung Diseases
Nursing Care Plan (NCP) for Sickle Cell Anemia
Nursing Care Plan (NCP) for Skin cancer – Melanoma, Basal Cell Carcinoma, Squamous Cell Carcinoma
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan (NCP) for Thrombocytopenia
Nursing Care Plan (NCP) for Thrombophlebitis / Deep Vein Thrombosis (DVT)
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Alzheimer’s Disease
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Aortic Aneurysm
Nursing Care Plan (NCP) for Arterial Disorders
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan for Coronary Artery Disease (CAD)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan for Fibromyalgia
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan for Myocarditis
Nursing Care Plan for Nasal Disorders
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan for Pulmonary Edema
Nursing Care Plan for Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care Plan (NCP) for Sickle Cell Anemia
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Case Study for Head Injury
Nursing Case Study for Pediatric Asthma
Obstruction for Certified Emergency Nursing (CEN)
Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)
Pacemakers
Pain Management and Procedural Sedation for Certified Emergency Nursing (CEN)
Pain Management for the Older Adult – Live Tutoring Archive
Pain Management Meds – Live Tutoring Archive
Pain (Acute, Chronic) for Progressive Care Certified Nurse (PCCN)
Palliative Care for Progressive Care Certified Nurse (PCCN)
Parasympathomimetics (Cholinergics) Nursing Considerations
Asthma
Pediatric Bronchiolitis Labs
Platelets (PLT) Lab Values
Pleural Effusion for Certified Emergency Nursing (CEN)
Preload and Afterload
Pulmonary Embolism for Progressive Care Certified Nurse (PCCN)
Pulmonary Embolus for Certified Emergency Nursing (CEN)
Pulmonary Hypertension for Progressive Care Certified Nurse (PCCN)
Pulmonary Hypertension for Certified Emergency Nursing (CEN)
Red Blood Cell (RBC) Lab Values
Red Cell Distribution Width (RDW) Lab Values
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Distress Syndrome for Certified Emergency Nursing (CEN)
Respiratory Failure (Acute, Chronic, Failure to Wean) for Progressive Care Certified Nurse (PCCN)
Respiratory Infections (Pneumonia) for Progressive Care Certified Nurse (PCCN)
Sodium and Potassium Imbalance for Certified Emergency Nursing (CEN)
Spinal Cord Injury
Spinal Cord Injury Case Study (60 min)
Steroids – Side Effects Nursing Mnemonic (6 S’s)
Systemic Lupus Erythematosus (SLE)
Thrombocytopenia
Thromboembolic Disease- Deep Vein Thrombosis (DVT) for Certified Emergency Nursing (CEN)
Treatment of Sickle Cell Nursing Mnemonic (HOP to the hospital)
Troponin I (cTNL) Lab Values
Valvular Heart Disease for Progressive Care Certified Nurse (PCCN)
Vascular Disease for Progressive Care Certified Nurse (PCCN)
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Warfarin (Coumadin) Nursing Considerations