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Nursing care during Primary Angioplasty - Essay Example

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Nursing Care and Primary Angioplasty Vs. Thrombolysis The case of a 45 years old male who was brought to the hospital with severe central chest pain is considered. ECG showed massive ST elevation in the antero-lateral leads. On arrival at the hospital, the patient’s signs and symptoms such as TPR (temperature, pulse and respiratory rate), blood pressure and blood glucose levels were recorded…
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Nursing care during Primary Angioplasty
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Download file to see previous pages Details to be collected typically include – onset duration progress of cardiac symptoms, similar complaints in the past, any other major illnesses like diabetes, hypertension, medicines with dosage, previous surgeries, any allergies, etc. Details are provided to the respective physician and orders noted accordingly. Meanwhile the patient and the relatives are provided counseling and assurance. Coronary Angioplasty is planned in this patient to widen the occluded coronary artery. These arteries supply blood and oxygen to the heart muscles. These arteries get occluded due to fatty tissue or atheroma resulting in reduced blood supply to the heart causing chest pain. Angioplasty is performed to open up the blocked vessels by compressing fatty tissue against anterior coronary vessel wall. This procedure helps to improve blood flow through the vessels to the heart muscles and helps in relieving chest pain. Also, this procedure is advised when - a. Medicines like calcium channel blocker, beta adnergic blockers or nitrates fail to correct coronary heart disease symptoms (NICE technology appraisal guidance 71) or b. There is recurrence of chest pain post CABG (Coronary Artery Bypass Graft surgery). Coronary angioplasty can be planned procedure or an emergency procedure in the case of heart attack and unstable chest pain with acute myocardial infarction. (Coronary Angioplasty and Stents) This operation is performed either through radial artery or femoral artery. Radial route is more popular in recent times because radial artery is easily accessible and palpable. Its superficial location makes it easy to compress to achieve homeostasis later on. Normal Allen’s test ensures dual blood supply to hand. So in case of bruise to radial artery or radial blood flow shunt, hands will still receive perfusion through Ulnar artery without feeling any damage. There is less chance of nerve injury in radial method. This approach provides comfort to the patient as it allows them ability to mobilize. It is easier for the patient to notice and control any bleeding from the radial incision, the femoral artery lies deeper in leg, so compressing the artery is difficult and by the time hematoma is noted bleeding would be significant. Radial artery method is cost effective too. (Radial Approach to Cardiac Catheterisation). Coronary Angiography is performed with the Angioplasty in an emergency. Angiogram allows doctor to look inside coronary arteries and find out how severe and where the narrowed areas are. (Coronary Angioplasty and Stents) Patient is advised what medicines to be avoided on the day of the procedure, such as aspirin or any anti coagulant, which medicines should be stopped few days before the procedure and what additional medicines need to be taken. He/she is also informed about the details of the procedure along with the effect of anesthetic drugs during and after the procedure. Doctor explains about the nature of pain the patient may have. Nursing staff ensures that patient would not eat or drink anything 4 -5 hours before the procedure. Proper consent is taken from the patient and relatives informing them about the complication involved in it. Nursing staff prepares the patient for the procedure by checking ...Download file to see next pagesRead More
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