A patient had a cardiac catheterization and is now in the recovery area. What nursing interventions should be included in the plan of care? Select all that apply.

Choice A rationale Assessing peripheral pulses distal to the insertion site is a critical nursing intervention following cardiac catheterization. The procedure involves arterial puncture, which carries a risk of arterial occlusion, thrombosis, or embolism. Regular pulse checks help ensure that blood flow to the extremity remains adequate. Comparing the pulse strength to the baseline and the unaffected limb allows for early detection of vascular compromise, which requires immediate intervention to prevent permanent tissue damage or limb ischemia. Choice B rationale The insertion site for a cardiac catheterization, usually the femoral or radial artery, must be monitored closely for bleeding or hematoma formation. Because the procedure involves a large-bore puncture in a high-pressure vessel, the risk of hemorrhage is significant, especially if the patient is on anticoagulants. A hematoma can also lead to local tissue compression or nerve injury. Frequent visual inspection and palpation of the site are necessary to ensure the effectiveness of the pressure dressing. Choice C rationale Evaluating the temperature and color of the affected extremity provides essential data regarding the neurovascular status. A cold, pale, or cyanotic limb suggests impaired arterial circulation or a possible clot at the puncture site. Monitoring these parameters alongside pulse checks provides a comprehensive assessment of perfusion. If the extremity becomes cool or mottled, it indicates a medical emergency such as an acute arterial occlusion, which is a known complication of invasive percutaneous cardiovascular procedures. Choice D rationale Early ambulation is usually contraindicated immediately following cardiac catheterization if a femoral approach was used. Patients are typically required to remain on bed rest with the affected extremity kept straight for several hours to prevent arterial bleeding and allow the puncture site to seal properly. Encouraging ambulation too soon increases the risk of hematoma formation or retroperitoneal hemorrhage. Therefore, the nurse must enforce strict activity restrictions according to the facility protocol rather than encouraging early movement. Choice E rationale Restricting fluid intake is generally contraindicated after cardiac catheterization unless the patient has a specific condition like severe heart failure. Patients receive radiopaque contrast dye during the procedure, which is nephrotoxic. Increasing fluid intake, either orally or intravenously, is encouraged to help flush the dye through the kidneys and prevent contrast-induced nephropathy. Adequate hydration ensures that the concentration of the dye in the renal tubules is minimized, thereby protecting the patient's renal function post-procedure.