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Assessment of the Cardiovascular System (Physical Assessment …

- - - - Baroreceptors: inhibit the vasomotor center (causing a drop in BP) when walls are stretched by an increased BP; located in the arch of the aorta and carotid arteries.
        Peripheral chemoreceptors: sensitive to hypoxia; send impulses along the vagus nerves to activate vasoconstriction and inc BP; located in carotid arteries and aortic arch. (central chemoreceptors are stimulated by hypercapnia)
        Stretch receptors: sensitive to pressure or volume changes. Can sense reduced volume and sends few impulses to the CNS, which stimulates the sympathetic nervous system to inc HR and constrict peripheral blood vessels.
- - - - Cardiac Cath complications
        Left Sided and coronary Arteriography
        
        MI
        
        Stroke
        
        Arterial bleeding
        
        Thromboembolism
        
        Lethal dysrhythmias
        
        Right Sided
        
        Thrombophlebitis
        
        Pulmonary embolism
        
        Vagal response
        
        Right or Left Sided
        
        Cardiac tamponade
        
        Hypovolemia
        
        Pulmonary edema
        
        Hematoma or blood loss
        
        Reaction to contrast media
        
        Arterial dissection
        
        Death
      - Cardiac Cath Follow-up Care
        
        Restrict pt to bedrest and keep the insertion site extremely straight. (soft knee brace can be applied) at least 2-6 hrs
        
        Monitor vs every 15 min for 1 hour, then every 4 hours
        
        Assess the insertion site for bloody drainage or hematoma formation
        
        Assess peripheral pulses in the affected extremity, as well as skin temp and color, with every vs check.
        
        Because the contrast acts as an osmotic diuretic, monitor urine output and ensure the pt recieves sufficient oral and IV fluids for adequate secretion of the medium.
        
        Paid meds for the insertion site or back discomfort may be prescribed.
        
        Remind the pt to limit activity for several days, leave the dressing in place for at least the first day at home, observe the site over the next few weeks for s/s of infection.
        
        Critical
        
        if the pt experiences s/s of cardiac ischemia such as chest pain, dysrhythmias, bleeding, hematoma formation, or a dramatic change in peripheral pulses in the affected extremity, contact the rapid response team or physician immediately. Neurologic changes indicating a possible stroke, such as visual disturbances, slurred speech, swallowing difficulties, and extremity weakness should also be reported immediately.