👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: heart cath · coronary angiogram · angiography
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Use this quick-reference guide to spot, treat, and prevent Cardiac Catheterization on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
✅ Before
Assess iodine/shellfish allergy
Hold metformin → lactic acidosis
Check renal function (contrast)
✅ After
Lie flat, leg straight 2-6h
Check distal pulses, color, temp
↑ fluids → flush contrast
🚩 Report
Bleeding/hematoma at site
Cool pale pulseless limb → occlusion
Chest pain, arrhythmia
📚 Cardiac Catheterization — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Cardiac catheterization threads a catheter through a femoral or radial artery into the heart and coronary vessels, usually with iodinated contrast, to evaluate coronary artery disease, chamber pressures, and valve function. It may be combined with angioplasty and stent placement. Memory aid: check the pulse below the puncture, keep the leg straight, and watch for bleeding.
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Key points
Understand these first
Iodinated contrast dye is used, so allergies to shellfish, iodine, or prior contrast reactions must be assessed beforehand.
After a femoral approach the patient keeps the affected leg straight and lies flat for several hours to prevent bleeding.
The dye causes a transient warm, flushing sensation and a metallic taste, which is expected.
Distal pulses, color, temperature, and sensation of the affected extremity are monitored frequently after the procedure.
Contrast is nephrotoxic, so hydration and monitoring of renal function are important.
Metformin is typically held before and after the procedure to reduce the risk of lactic acidosis with contrast.
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Nursing priorities
What to do, in order
Verify consent and assess for iodine or contrast allergy and baseline renal function.
Mark and document distal pulses before the procedure for post-procedure comparison.
Keep the patient flat with the affected extremity straight and the head of bed low after a femoral approach.
Assess the puncture site for bleeding or hematoma and check distal pulses, color, and sensation frequently.
Encourage fluids and monitor urine output to flush contrast and protect the kidneys.
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Red flags — report now
Escalate immediately
Report bleeding, an expanding or pulsating hematoma at the insertion site, indicating possible hemorrhage or pseudoaneurysm.
Report a cool, pale, pulseless extremity or new numbness suggesting arterial occlusion.
Report chest pain, dysrhythmias, or shortness of breath after the procedure.
Never raise the head of the bed or flex the affected leg too soon after a femoral approach.
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Labs & values
Numbers to know
BUN: 10-20 mg/dL
Creatinine: 0.6-1.2 mg/dL
eGFR: greater than 60 mL/min/1.73 m2
Potassium: 3.5-5.0 mEq/L
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Patient teaching
What patients must know
You may feel a warm flush and a metallic taste when the dye is injected, which is normal.
Keep the affected leg straight and lie flat as instructed to prevent bleeding.
Drink extra fluids afterward to help flush the dye from your kidneys.
Apply firm pressure and call for help if the site starts to bleed.
Report chest pain, a cold or numb leg, or any bleeding right away.
❓ Cardiac Catheterization: NCLEX FAQs
What are the priority nursing interventions for Cardiac Catheterization?
Verify consent and assess for iodine or contrast allergy and baseline renal function. Mark and document distal pulses before the procedure for post-procedure comparison. Keep the patient flat with the affected extremity straight and the head of bed low after a femoral approach. Assess the puncture site for bleeding or hematoma and check distal pulses, color, and sensation frequently.
What are the warning signs of Cardiac Catheterization a nurse must report?
Report bleeding, an expanding or pulsating hematoma at the insertion site, indicating possible hemorrhage or pseudoaneurysm. Report a cool, pale, pulseless extremity or new numbness suggesting arterial occlusion. Report chest pain, dysrhythmias, or shortness of breath after the procedure. Never raise the head of the bed or flex the affected leg too soon after a femoral approach.
What do I need to know about Cardiac Catheterization for the NCLEX?
Iodinated contrast dye is used, so allergies to shellfish, iodine, or prior contrast reactions must be assessed beforehand. After a femoral approach the patient keeps the affected leg straight and lies flat for several hours to prevent bleeding. The dye causes a transient warm, flushing sensation and a metallic taste, which is expected. Distal pulses, color, temperature, and sensation of the affected extremity are monitored frequently after the procedure.
What patient teaching is important for Cardiac Catheterization?
You may feel a warm flush and a metallic taste when the dye is injected, which is normal. Keep the affected leg straight and lie flat as instructed to prevent bleeding. Drink extra fluids afterward to help flush the dye from your kidneys. Apply firm pressure and call for help if the site starts to bleed.
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Quick Tip
Iodinated contrast dye is used, so allergies to shellfish, iodine, or prior contrast reactions must be assessed beforehand.