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Soru

Zorluk: KolayReduction of Risk Potential

A nurse is caring for a client who returned to the medical-surgical unit 1 hour ago following a cardiac catheterization performed via the right femoral artery. Which intervention should the nurse prioritize to reduce the client's risk for a post-procedure complication?

  1. Instruct the client to keep the right leg straight and minimize movement.Cevap
  2. B
    Elevate the head of the bed to a high-Fowler's position.
  3. C
    Delegate the hourly palpation of the right pedal pulse to the unlicensed assistive personnel (UAP).
  4. D
    Monitor for a sudden drop in systolic blood pressure as the first indicator of internal bleeding.

Cevap

Instruct the client to keep the right leg straight and minimize movement.
Following a femoral cardiac catheterization, the most critical intervention to reduce the risk of hemorrhage is maintaining the affected extremity in a straight, neutral position. This prevents the groin crease from bending, allowing the arterial puncture site to clot securely.

Adım Adım Çözüm

1
Identify the procedure and the specific anatomical site used.
The client had a cardiac catheterization via the right femoral artery.
Knowing the insertion site determines the specific local complications to anticipate.
2
Determine the most significant acute post-procedure risk.
The primary immediate risk is arterial hemorrhage or hematoma formation at the femoral puncture site.
The femoral artery is a major vessel under high pressure, making bleeding a life-threatening risk.
3
Select the intervention that directly mitigates this specific risk.
Keeping the affected leg straight prevents mechanical stress on the arterial puncture site.
Bending the hip joint would disrupt the clot formation and promote bleeding.

Anahtar Kavram

Post-Cardiac Catheterization Hemorrhage Prevention
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Konular

Reduction of Risk Potential

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