NORCET 10 Mains: After cardiac catheterization in a child, which post-procedure nursing management is appropriate?

NORCET 10 Mains

Child Health Nursing (Pediatrics)

Easy

Appeared in: NORCET 10 Mains

Explanation

Frequent monitoring (every 15 minutes) is the standard of care immediately after cardiac catheterization to detect early signs of complications.
The primary risks being monitored for are hemorrhage from the arterial access site and cardiac arrhythmias resulting from catheter irritation to the heart.
Hypotension and tachycardia are key signs of bleeding, while an irregular pulse can indicate an arrhythmia, making frequent checks of all vital signs essential for patient safety.

Option B: Counting the heart rate for only 30 seconds is insufficient to accurately detect potential dysrhythmias, a known complication following cardiac catheterization.
Option C: Counting the pulse for only 15 seconds is highly likely to miss irregularities or subtle changes in rhythm. It is not a reliable method for assessment after an invasive cardiac procedure.
Option D: Checking blood pressure only hourly allows too much time for a potentially life-threatening hemorrhage to go undetected in the critical first hours post-procedure.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Post-procedure nursing care following pediatric cardiac catheterization in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Prompt identification of post-catheterization complications like bleeding or thrombosis is a core nursing safety responsibility to prevent limb ischemia, shock, or cardiac arrest.
Nurses must maintain the child's affected extremity in a straight position for several hours post-procedure to maintain pressure on the arterial puncture site and prevent hematoma or hemorrhage.
What if? The child suddenly complains of a 'wet feeling' at the groin dressing and their heart rate increases from 110 to 140 bpm. The nurse's FIRST action would be to apply direct, firm pressure to the insertion site and simultaneously call for immediate help, as this indicates active hemorrhage.

How to Approach the Question

First, identify the core of the question: It asks for the most appropriate nursing action immediately following an invasive procedure (cardiac catheterization) in a child.
Next, recall the major immediate risks associated with this procedure: bleeding/hemorrhage, blood clots (thrombosis), and irregular heartbeats (arrhythmias).
Then, evaluate each option based on its ability to monitor for these specific risks. The best action will be the one that provides the most frequent and comprehensive monitoring.
Compare the timeframes provided in the options. '15-minute intervals' is the most frequent monitoring schedule offered, which directly addresses the high-risk nature of the immediate post-procedure period.
Eliminate the other options: Hourly checks are too infrequent for the initial phase, and short pulse counts are inaccurate for detecting arrhythmias.

Concept Tested & Keywords

Concept Tested: Post-procedure nursing care following pediatric cardiac catheterization.
Stem keywords: cardiac catheterization, child, post-procedure, nursing management
Lead-in keywords: appropriate
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 2 (pp 239-476 of 713) p. 107-109

E6 Medicine Harrison 22e Part 1 p. 1950-1952

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 762-764