课件：心内科冠心病护理.ppt

When the balloon is inflated, the vessel is totally blocked, which results in ischemia. The patient may have angina or experience a drop in blood pressure as well as arrhythmias. An ECG is continuously and carefully watched on the monitor, as well as the blood pressure which is recorded via the guiding catheter. The number of balloon inflations as well as the time per inflation is recorded. In most cath labs there is one physician performing the procedure, assisted by an additional physician, or a nurse, and one nurse who is monitoring the vital signs and recording the necessary data. This nurse or technician also can handle any complications that may occur. * * Since the advent of the first Palmaz-Schatz Stent, there have been significant improvements in design and ease of use. Because of these factors, stent use has come from an initial 10% to a current 80% of procedures. * Stents are mounted on a balloon catheter, which is advanced to the lesion site and then inflated. The balloon pushes the stent into the vessel wall. Then the balloon catheter is deflated and withdrawn leaving the stent in place. * * Once the femoral artery is located by palpation, local anesthesia is superficially injected into the skin. Two to three minutes following infiltration, a small skin incision is made and a subcutaneous tunnel is created. An arterial puncture is made and a J-tipped guidewire is straightened and introduced into the needle to “track” the artery. * The needle is removed leaving the “J” wire in place. A sheath/dilator assembly is introduced over the wire. The sheath must be the same French size as the catheter or larger. Sheath French size is indicated as inner diameter (ID). Size is selected based on the largest size catheter the physician expects to use during the procedure. An 8F sheath will accommodate a maximum 8F guide or diagnostic catheter. The short “J” wire is removed once the sheath is in place. * The catheter is passed through the sheath, over the