Which does the nurse include in postprocedure nursing care after a femoral angiogram?
1. Assist the client to void in the bathroom within 2 hours.
2. Assess the groin for hematoma, bleeding, and induration.
3. Report the client's urine output less than 150 ml in 6 hours.
4. Apply antihistamine lotion to extremities for itching or rash.
2
2. The radiologist inserts the angiographic catheter in the groin for a femoral angio-gram; thus, because a major artery is accessed for the procedure, the client has a high risk for postprocedure bleeding and thromboembolic events from wound dehiscence, anticoagulation, and bed rest. For early detection of postangiographic bleeding, the nurse monitors the client for subcutaneous discoloration and induration, which poten-tially indicate a hematoma, and bright red bleeding according to agency policy. In addition, the nurse monitors peripheral pulses for early detection of a thromboembolic event to prevent tissue damage or loss.
1. The client remains on bed rest and lays flat for 6 to 12 hours after the procedure to ensure hemostasis of the insertion site. The nurse prevents the client from flexing the hips or thighs but encourages the client to flex and extend the toes and ankles to promote venous return.
3. The client's urine output should remain above 30 ml/hr, depending on the body surface area of the client, to prevent renal insufficiency. The contrast medium is po-tentially nephrotoxic and the health care team collaborates to maintain dilute urine and flush the dye out of the system quickly.
4. Applying an antihistamine to the extremities is inadequate for a hypersensitivity reaction because the reactions tend to be systemic; parenteral or oral therapy is indi-cated.
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