What are key nursing priorities after a percutaneous coronary intervention (PCI)?

• A. Focus on diet.
• B. Vascular access site monitoring for bleeding/hematoma, continual ECG monitoring, chest pain assessment, vital signs, and activity restrictions.
• C. Remove monitoring after 30 minutes.
• D. Only monitor blood pressure.

Answer: (B)

After a PCI, the focus is on preventing complications from the vascular access and detecting issues early to protect myocardial perfusion. The access site (where the catheter entered) is a prime bleeding risk, so you monitor for any bleeding, oozing, hematoma, swelling, or chest wall tenderness, and you routinely check distal pulses and limb perfusion to ensure the leg or arm remains healthy. Continuous ECG monitoring is essential because the heart can develop arrhythmias or exhibit recurrent ischemia in the immediate post-procedure period, especially as the vessels equilibrate after reperfusion. Regular chest pain assessment helps catch early signs of recurrent ischemia or stent-related issues. Vital signs provide early clues to instability from bleeding or cardiac problems, including abnormal blood pressure or heart rate. Activity restrictions protect the access site, reduce the risk of bleeding or dislodgement of the stent, and help prevent re-occlusion. Together, these priorities form a comprehensive post-PCI nursing plan that emphasizes monitoring for bleeding, rhythm disturbances, ischemia, hemodynamic stability, and careful mobilization per protocol.