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Difficulty: MediumBasic Care and Comfort

Following a right femoral cardiac catheterization, a client is admitted to the medical-surgical unit. As part of providing basic comfort and safety, which actions by the practical nurse are appropriate? Select all that apply.

  1. Keep the head of the bed at an angle of 30 degrees or lower.Answer
  2. Instruct the client to keep the right leg straight and avoid bending it.Answer
  3. Provide a fracture bedpan when the client reports the urge to urinate.Answer
  4. D
    Position a pillow under the client's knees to reduce strain on the lower back.
  5. E
    Raise the head of the bed to a high-Fowler's position while the client eats meals.
  6. F
    Assist the client to stand at the bedside to promote regular voiding.

Answer

The appropriate actions are keeping the head of the bed at or below 30 degrees, keeping the right leg straight, and using a fracture bedpan for elimination.
Following a femoral cardiac catheterization, strict hemostasis is vital. The client must remain on bed rest with the affected leg fully extended. Keeping the head of the bed elevated no more than 30 degrees prevents hip flexion, which could dislodge the clot. When elimination is needed, a fracture bedpan is the appropriate choice because its low profile requires minimal hip elevation, adhering to the strict movement restrictions.

Step-by-Step Solution

1
Identify the primary physiological risk associated with a femoral cardiac catheterization.
The main risk is hemorrhage or hematoma formation at the femoral artery puncture site in the groin.
Arterial access points are under high pressure and require strict hemostasis protocols post-procedure.
2
Determine the positioning constraints required to protect the insertion site.
The affected hip must remain straight (unflexed). Therefore, the head of the bed must remain low (≤30 degrees), and the right leg must be kept fully extended.
Flexion of the hip joint places physical stress on the femoral artery, increasing the likelihood of disrupting the newly formed clot.
3
Select basic care interventions that align with these strict mobility constraints.
Using a fracture pan is necessary because it minimizes the need to lift the hips. Interventions like ambulation, sitting completely upright, and placing pillows under the knees all cause dangerous hip flexion and must be avoided.
Basic nursing care (such as assisting with elimination or eating) must be adapted to the physical limitations of the prescribed bed rest and limb immobilization.

Key Concept

Post-procedure basic care for femoral arterial access requires strict bed rest, maintaining the affected extremity in a straight position, and avoiding hip flexion to prevent severe hemorrhage.
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Topics

Basic Care and Comfort

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