Page 71 - Critical Care Notes

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Diagnostic Tests Prior to PCI
■ ECG
■ Echocardiogram
■ Chest x-ray
■ Lab tests: cardiac markers, serum electrolytes, coagulation studies, BUN,
creatinine, CBC
Management Post PCI
■ Administer antiplatelet agents (aspirin, ticlopidine, clopidogrel).
■ Administer IV infusion of glycoprotein IIb/IIIa inhibitors (eptifibatide).
■ Monitor for signs and symptoms of bleeding at catheter site.
■ Maintain pressure dressing to insertion site for 12 hr after procedure.
■ Keep the involved leg straight.
■ Set HOB to 45° or less.
■ Monitor for cardiac arrhythmias.
■ Monitor for chest pain and report immediately to MD. Give O 2 , NTG, isosor-
bide (Imdur), or nifedipine (Procardia); obtain 12-lead ECG.
Complications
■ Abrupt closure of dilated segment or stent thrombosis
■ Angina, MI, vasospasm, coronary artery dissection
Other interventional cardiology techniques include:
■ Laser angioplasty
■ Atherectomy, directional coronary atherectomy
■ Rotational ablation
■ Brachytherapy
Stent Insertion

CV