A client returns from a cardiac catheterization procedure via femoral artery access. What is the PRIORITY assessment for the first 2 hours post-procedure?

CARDIAC CATHETERIZATION via FEMORAL ARTERY ACCESS introduces a large catheter into the femoral artery. After removal, a small hole is left in a major artery — HEMORRHAGE and VASCULAR COMPLICATIONS are the primary post-procedure risks.

Priority post-procedure assessments:

Site inspection: bleeding (check directly and under the client — blood can pool under the client undetected); hematoma (expanding lump/discoloration at site — concerning if rapidly enlarging or causing neurovascular compromise).

Note: femoral access requires the client to keep the leg STRAIGHT and LIMIT movement for the prescribed period (typically 2-6 hours depending on closure method); VASCULAR STATUS of the affected extremity: PULSES (dorsalis pedis and posterior tibial pulses distal to the site — check every 15 minutes initially).

Circulation: COLOR (pale = arterial occlusion; cyanotic = venous obstruction); TEMPERATURE (should be warm — cold = reduced perfusion); CAPILLARY REFILL (<3 seconds = adequate); SENSATION AND MOVEMENT (numbness, tingling, weakness = neurovascular compromise).

Frequency: typically every 15 minutes for the first hour, every 30 minutes for the next hour, then every hour.

Complications to detect:

Bleeding: may be external or internal (retroperitoneal hematoma — may not be visible but presents with flank/back pain, hypotension, tachycardia, dropping H&H).

Arterial occlusion: absent or diminished distal pulse, pain, pallor, paresthesia, paralysis — 'the 5 P's of arterial occlusion'.

Pseudoaneurysm: pulsatile mass at site.

Arteriovenous fistula: palpable thrill at site.

Vasovagal: hypotension, bradycardia, nausea.

Report to RN: any absent or diminishing distal pulse; expanding hematoma; bleeding that doesn't stop with pressure; hypotension or tachycardia; extremity pallor, cyanosis, or coldness.