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Acute Myocardial Infarction

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1. Describe nursing care of the post angioplasty patient.
A coronary angioplasty is a procedure to open an area of the arterial blockage in the heart that has become narrowed. This allows better blood flow through the artery and to the heart muscle. It is often done with a catheter that has an inflatable small sausage-shaped balloon at its tip.
Coronary angioplasty is being increasingly used as a treatment for coronary artery disease; the proper evaluation and management of patients after the procedure are important issues. Although coronary angioplasty is a complex technical procedure, the methods routinely used to evaluate its results have many limitations. The management of the patient during the first 24 hours after angioplasty should focus on the prevention, detection, and if necessary treatment of acute vessel closure.
Assessment: When the patient returns from the cardiac catheterization laboratory, the stability of the patient should be established initially. This will include, but is not limited to, EKG, vital signs, oxygenation level, urine output, cardiac, respiratory, pulmonary, gastrointestinal, and gentle urinary assessment. Particular attention must be paid to the peripheral vascular assessment of the lower extremities. Often the patient may return from the cardiac catheterization laboratory with a sheath in place. If this is the case, the institutional procedures for caring for sheaths should be applied. Some institutions, may allow the nurse to remove that sheath. Other institutions require that the physician removes the sheath.in the latter instance, the institutions policies and procedures must be followed. In some institutions an ACT may be required to check the patients clotting time prior to sheath removal. Generally, the nurse should monitor vital signs, and distal pulses every 15 minutes X 4, every 30 minutes X 2, then every hour X 2, then

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