General

Synonym/Acronym:
Angiogram, arteriography.

Rationale
To visualize and assess internal organs/structures for abnormal or absent anatomical features, abscess, aneurysm, cancer or other masses, infection, or presence of disease.

Patient Preparation
There are no activity restrictions unless by medical direction. Instruct the patient to fast and restrict fluids for 8 hr, or as ordered, prior to the procedure. Fasting may be ordered as a precaution against aspiration related to possible nausea and vomiting. The American Society of Anesthesiologists has fasting guidelines for risk levels according to patient status. More information can be located at www.asahq.org.

Note: Protocols regarding the use of iodinated contrast medium in patients with impaired kidney function and who are receiving metformin or drugs containing metformin for type 2 diabetes may vary by facility; the drug may be discontinued on the day of the test and continue to be withheld for 48 hr after the test. Kidney function should be assessed per facility protocol before use of metformin is resumed (e.g., Cr, eGFR, hydration, or clinical assessment).

Regarding the patient’s risk for bleeding, the patient should be instructed to avoid taking natural products and medications with known anticoagulant, antiplatelet, or thrombolytic properties or to reduce dosage, as ordered, prior to the procedure. Number of days to withhold medication is dependent on the type of anticoagulant. Note the last time and dose of medication taken. Protocols may vary among facilities.

Patients on beta blockers before the surgical procedure should be instructed to take their medication as ordered during the perioperative period.

Normal Findings

• Normal structure, function, and patency of organ vessels
• Contrast medium normally circulates throughout area of inquiry symmetrically and without interruption
• No evidence of obstruction, variations in number and size of vessels and organs, malformations, cysts, or tumors

Critical Findings and Potential Interventions

• Abdominal abscess
• Abdominal aneurysm
• Pulmonary embolism
• Stroke
• Adrenal disease

Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.