Which nursing intervention should the nurse implement after right femoral artery catheterization?

Appeared in: AIIMS Bhatinda NO - 2019

Explanation

Procedures involving femoral artery access, such as angiography, frequently use iodinated contrast dye.
This contrast dye is nephrotoxic, meaning it can cause damage to the kidneys, a condition known as contrast-induced nephropathy (CIN).
Assessing renal status by monitoring urine output (ideally hourly at first) and reviewing blood urea nitrogen (BUN) and creatinine levels is essential for early detection of kidney injury.
Patients with pre-existing renal disease, diabetes, or dehydration are at a higher risk for CIN.

Option A: Performing range of motion on the affected leg is contraindicated immediately after the procedure. The leg must be kept straight and immobilized to ensure hemostasis at the arterial puncture site.
Option C: Placing the client in a high Fowler's position causes significant flexion at the hip, which increases pressure on the femoral artery. This can disrupt the clot at the puncture site and cause a hemorrhage.
Option D: Assessing the gag reflex is unrelated to a procedure performed on the femoral artery in the leg.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Post-procedure nursing care following femoral artery catheterization in the correct sequence, documenting the action clearly, and monitoring for the expected response.
The two most critical, immediate risks after femoral artery catheterization are hemorrhage at the puncture site and systemic renal failure from contrast dye.
Nurses must prioritize interventions that address these risks: immobilizing the leg and monitoring renal function.
A serious but less common complication is retroperitoneal bleeding, where blood leaks from the artery into the space behind the abdomen. A key sign is severe, unexplained back or flank pain.

How to Approach the Question

First, identify the procedure mentioned in the question: 'right femoral artery catheterization'.
Recall the major immediate risks associated with this procedure. The two primary risks are bleeding/hemorrhage from the arterial puncture site and kidney damage from the contrast dye used.
Evaluate each option based on these risks.
Option A (ROM exercises) and Option C (high Fowler's) both involve moving or flexing the leg/hip, which directly increases the risk of bleeding. Therefore, they are incorrect and contraindicated.
Option D (gag reflex) is unrelated to a procedure on the leg and can be eliminated.
Option B (assess renal status) directly addresses the risk of kidney damage from contrast dye, making it a crucial and correct nursing intervention.

Concept Tested & Keywords

Concept Tested: Post-procedure nursing care following femoral artery catheterization.
Stem keywords: nursing intervention, right femoral artery catheterization
Lead-in keywords: implement

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E6 Nursing Fundamentals Potter Perry 12e Part 4 pp. 149-151, 169-171

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