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Post-Angiography Nursing Care Plan
Assessment
Vital signs: monitor BP, HR, respiratory rate, temperature, and oxygen saturation every 15 minutes for the first hour, every 30 minutes for the next 2 hours, then hourly per unit protocol.
Neurovascular status of the access limb: assess pulses (palpable and/or Doppler), capillary refill, color, temperature, sensation, motor function, and pain at the access site every 15 minutes for the first hour, then per facility policy.
Access site inspection: observe for bleeding, hematoma, swelling, bruising, or oozing. Note dressing condition and presence of visible pulsatile bleeding.
Pain level: use a pain scale and document location, quality, intensity, and response to interventions.
Peripheral perfusion of distal extremity and contralateral limb for comparison.
Hemostasis device or closure device status: ensure device integrity and position.
Urine output and hydration status.
Allergic reaction or contrast-induced effects: monitor for itching, rash, dyspnea, wheeze, or hypotension.
Signs of contrast-induced nephropathy: monitor serum creatinine (baseline and 24–48 hours post), urine output, and report oliguria.
Nursing Diagnoses (Common)
Risk for bleeding related to puncture of arterial/venous vessel during angiography and anticoagulation therapy.
Acute pain related to vascular access and procedural manipulation.
Impaired tissue perfusion (peripheral) related to vascular compromise/hematoma at access site.
Risk for infection related to invasive vascular access.
Risk for contrast-induced nephropathy related to iodinated contrast media.
Anxiety related to procedure recovery and concern about complications.
Goals/Expected Outcomes
Patient will maintain hemodynamic stability within baseline parameters.
No evidence of active bleeding at access site; dressing remains dry and intact.
Distal pulses and neurovascular function remain intact and equal to baseline.
Pain will be controlled to a tolerable level (as defined by patient) with interventions.
No signs of infection develop at the access site during hospitalization.
Serum creatinine remains within acceptable limits or any rise is identified and managed promptly.
Patient demonstrates understanding of post-procedure restrictions and signs/symptoms to report.
Nursing Interventions and Rationale
Monitor vital signs frequently per protocol.
Rationale: Early detection of hypotension, tachycardia, fever, or respiratory compromise can indicate bleeding, reaction, or other complications.
Inspect and palpate access site frequently; maintain direct visualization if dressing is small/transparent.
Rationale: Timely identification of bleeding or hematoma allows immediate intervention to prevent expansion and limb ischemia.
Apply and maintain direct pressure or hemostatic device as ordered; do not remove external pressure dressings without provider approval.
Rationale: Hemostasis devices and pressure reduce risk of bleeding at arterial puncture sites.
Keep the access limb straight and immobilized for prescribed timeframe (commonly 4–6 hours for femoral; site-specific instructions for radial) and avoid hip flexion if femoral approach.
Rationale: Movement increases risk of bleeding or hematoma formation at arterial puncture.
Monitor neurovascular status (pulses, capillary refill, sensation, motor function) frequently.
Rationale: Early signs of compromised perfusion require immediate intervention to prevent ischemic injury.
Check distal pulses with Doppler if pulses are weak or absent; notify provider immediately for diminishing pulses or signs of ischemia.
Rationale: Weak/absent pulses may indicate arterial occlusion or large hematoma compressing vessels.
Manage pain with prescribed analgesics and nonpharmacologic measures; reassess pain after interventions.
Rationale: Pain control improves patient comfort and reduces sympathetic responses that can affect hemodynamics.
Maintain bedrest as ordered; encourage deep breathing and coughing with splinting if needed to reduce pulmonary complications.
Rationale: Bedrest reduces stress on the access site; deep breathing prevents atelectasis.
Monitor urine output and fluid balance; administer IV fluids per protocol to promote renal perfusion, especially in patients with baseline renal impairment or those receiving contrast.
Rationale: Adequate hydration reduces risk of contrast-induced nephropathy.
Monitor lab results: hemoglobin/hematocrit for occult bleeding, serum creatinine for renal function.
Rationale: Drop in H/H indicates bleeding; creatinine rise signals nephropathy.
Educate patient and family about activity restrictions, wound care, signs/symptoms to report (bleeding, increasing pain, numbness, coolness, decreased pulses, fever),
Post-Angiography Nursing Care Plan
Assessment
Vital signs: monitor BP, HR, respiratory rate, temperature, and oxygen saturation every 15 minutes for the first hour, every 30 minutes for the next 2 hours, then hourly per unit protocol.
Neurovascular status of the access limb: assess pulses (palpable and/or Doppler), capillary refill, color, temperature, sensation, motor function, and pain at the access site every 15 minutes for the first hour, then per facility policy.
Access site inspection: observe for bleeding, hematoma, swelling, bruising, or oozing. Note dressing condition and presence of visible pulsatile bleeding.
Pain level: use a pain scale and document location, quality, intensity, and response to interventions.
Peripheral perfusion of distal extremity and contralateral limb for comparison.
Hemostasis device or closure device status: ensure device integrity and position.
Urine output and hydration status.
Allergic reaction or contrast-induced effects: monitor for itching, rash, dyspnea, wheeze, or hypotension.
Signs of contrast-induced nephropathy: monitor serum creatinine (baseline and 24–48 hours post), urine output, and report oliguria.
Nursing Diagnoses (Common)
Risk for bleeding related to puncture of arterial/venous vessel during angiography and anticoagulation therapy.
Acute pain related to vascular access and procedural manipulation.
Impaired tissue perfusion (peripheral) related to vascular compromise/hematoma at access site.
Risk for infection related to invasive vascular access.
Risk for contrast-induced nephropathy related to iodinated contrast media.
Anxiety related to procedure recovery and concern about complications.
Goals/Expected Outcomes
Patient will maintain hemodynamic stability within baseline parameters.
No evidence of active bleeding at access site; dressing remains dry and intact.
Distal pulses and neurovascular function remain intact and equal to baseline.
Pain will be controlled to a tolerable level (as defined by patient) with interventions.
No signs of infection develop at the access site during hospitalization.
Serum creatinine remains within acceptable limits or any rise is identified and managed promptly.
Patient demonstrates understanding of post-procedure restrictions and signs/symptoms to report.
Nursing Interventions and Rationale
Monitor vital signs frequently per protocol.
Rationale: Early detection of hypotension, tachycardia, fever, or respiratory compromise can indicate bleeding, reaction, or other complications.
Inspect and palpate access site frequently; maintain direct visualization if dressing is small/transparent.
Rationale: Timely identification of bleeding or hematoma allows immediate intervention to prevent expansion and limb ischemia.
Apply and maintain direct pressure or hemostatic device as ordered; do not remove external pressure dressings without provider approval.
Rationale: Hemostasis devices and pressure reduce risk of bleeding at arterial puncture sites.
Keep the access limb straight and immobilized for prescribed timeframe (commonly 4–6 hours for femoral; site-specific instructions for radial) and avoid hip flexion if femoral approach.
Rationale: Movement increases risk of bleeding or hematoma formation at arterial puncture.
Monitor neurovascular status (pulses, capillary refill, sensation, motor function) frequently.
Rationale: Early signs of compromised perfusion require immediate intervention to prevent ischemic injury.
Check distal pulses with Doppler if pulses are weak or absent; notify provider immediately for diminishing pulses or signs of ischemia.
Rationale: Weak/absent pulses may indicate arterial occlusion or large hematoma compressing vessels.
Manage pain with prescribed analgesics and nonpharmacologic measures; reassess pain after interventions.
Rationale: Pain control improves patient comfort and reduces sympathetic responses that can affect hemodynamics.
Maintain bedrest as ordered; encourage deep breathing and coughing with splinting if needed to reduce pulmonary complications.
Rationale: Bedrest reduces stress on the access site; deep breathing prevents atelectasis.
Monitor urine output and fluid balance; administer IV fluids per protocol to promote renal perfusion, especially in patients with baseline renal impairment or those receiving contrast.
Rationale: Adequate hydration reduces risk of contrast-induced nephropathy.
Monitor lab results: hemoglobin/hematocrit for occult bleeding, serum creatinine for renal function.
Rationale: Drop in H/H indicates bleeding; creatinine rise signals nephropathy.
Educate patient and family about activity restrictions, wound care, signs/symptoms to report (bleeding, increasing pain, numbness, coolness, decreased pulses, fever),
