Question

A 48 year old male is admitted to the interventional holding area after having a cardiac cath. The patient received a cardiac stent in the right coronary artery (RCA) and the insertion site was angiosealed. The insertion site is soft, no bruising noted, or active bleeding. Pulses are palpable in bilateral lower extremities. A sandbag in on the site which has to stay for another 1.5 hours per md orders. The patient is complaining of discomfort in the groin area and rates his pain 8 on 1-10 scale. In addition, the patient and his wife have verbalized they desire (but feel they will not be able to) to manage the new medication regime and post-op care and are having difficulty understanding why it is so important to take these new medications and quit smoking since he already “has his problem fixed with the stent placement”. He states he is going to have problems integrating these new “rules” into his daily life because he works around people who smoke all the time and does not want these medications to interfere with his life.interventional holding area after having a cardiac cath. The patient received a cardiac stent in the right coronary artery (RCA) and the insertion site was angiosealed. The insertion site is soft, no bruising noted, or active bleeding. Pulses are palpable in bilateral lower extremities. A sandbag in on the site which has to stay for another 1.5 hours per md orders. The patient is complaining of discomfort in the groin area and rates his pain 8 on 1-10 scale. In addition, the patient and his wife have verbalized they desire (but feel they will not be able to) to manage the new medication regime and post-op care and are having difficulty understanding why it is so important to take these new medications and quit smoking since he already “has his problem fixed with the stent placement”. He states he is going to have problems integrating these new “rules” into his daily life because he works around people who smoke all the time and does not want these medications to interfere with his life

Answer 1

RCA stent and cardiac care

Explanation:

Right coronary artery stent placement is done by insertion of a flexible thin catheter through insertion points in the arm or groin.

In the above case, the patient’s RCA stenting has been through groin insertion. Re-examination of the insertion site reveals a normal without any bruising or active bleeding.  

The patient’s groin pain at the insertion site will subside within a few days till it’s healed completely. Sandbag can reduce the pain.

The new medication regimen along with advice to stop smoking is to maintain a good cardiac health. But the patient feels is quite tough to follow since he works along with people who are smokers which can lead to passive smoking. Passive smoking is one of the potential risk factor for coronary artery diseases.  

Antiplatelet medications like clopidogrel, aspirin etc are prescribed to maintain normal blood flow.

The patient should take the new medications and should restrain from both active and passive smoking to reduce his cardiac risk factors.