Fundamentals of Nursing Q 444
A patient has returned to his room after femoral arteriography. All of the following are appropriate nursing interventions except:
A. Assess femoral, popliteal, and pedal pulses every 15 minutes for 2 hours.
B. Check the pressure dressing for sanguineous drainage.
C. Assess vital signs every 15 minutes for 2 hours.
D. Order a hemoglobin and hematocrit count 1 hour after the arteriography.
Correct Answer: D. Order a hemoglobin and hematocrit count 1 hour after the arteriography
A hemoglobin and hematocrit count would be ordered by the physician if bleeding were suspected. Arterial puncture occurs at the start of angiography and interventional radiology, and is a very important factor determining the success or failure of successive procedures. Recently, this procedure has been performed by a range of approaches depending on the type of surgery, e.g, through the radial artery.
Option A: The methods of hemostasis for the femoral artery include manual compression, which is the removal of the sheath and compression with the hands, and methods that apply compression devices1). Of these, manual compression requires absolute bed rest for a few hours. On the other hand, the level of patient discomfort is increased due to lengthy bed rest and the restriction of walking.
Option B: Moreover, hematoma in the punctured area of blood vessels, formation of a pseudoaneurysm, and vascular occlusions develop in approximately 1–5% of cases). A variety of hemostasis devices have been developed to treat these complications that allow for rapid recovery of patients from bed rest. These include Angio-seal device (collagen sponge and copolymer anchor) and percutaneous placement of a device (Prostar) that utilizes two nonabsorbable sutures (Perclose, Redwood City, CA, USA).
Option C: The other answers are appropriate nursing interventions for a patient who has undergone femoral arteriography. The Angio-seal device uses a method of adsorption with a collagen sponge placed within the blood vessels. The Prostar device uses a method in which the blood vessels are sutured. These hemostasis devices can reduce the discomfort and the time to hemostasis (clotting time) in the puncture area when used in patients, who cannot lie down in bed for a long time or in patients with low platelet values who have received anticoagulation treatments.