Page 1677 - Saunders Comprehensive Review For NCLEX-RN

compression or bed rest, and clients
may be out of bed in 1 to 2 hours.
l. Encourage fluid intake, if not
contraindicated, to promote renal
excretion of the dye and to replace
fluid loss caused by the osmotic
diuretic effect of the dye.
m. Monitor for nausea, vomiting, rash, or
other signs of hypersensitivity to the
dye.
Y. Intravascular ultrasonography (IVUS): A catheter with a
transducer is used as an alternative to injecting a dye into the
coronary arteries and detects plaque distribution and composition;
it also detects arterial dissection and the degree of stenosis of an
occluded artery.
III. Therapeutic Management
A. Percutaneous transluminal coronary angioplasty (PTCA)
1. Description (Fig. 52-3)
a. An invasive, nonsurgical technique in
which 1 or more coronary arteries are
dilated with a balloon catheter to open
the vessel lumen and improve arterial
blood flow
b. PTCA may be used for clients with an
evolving MI, alone or in combination
with medications, to achieve
reperfusion.
c. The client can experience reocclusion
after the procedure; thus, the
procedure may need to be repeated.
d. Complications can include arterial
dissection or rupture, embolization of
plaque fragments, spasm, and acute
MI.

e. Firm commitment is needed on

the client’s part to stop smoking,
adhere to diet restrictions, lose weight,
alter the exercise pattern, and stop any
behaviors that lead to progressive
artery occlusion.

2. Preprocedure interventions

a. Similar to preprocedure interventions
for cardiac catheterization
b. The PHCP may prescribe preprocedure
medications, including acetylsalicylic

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