Discharge advice
The advice given to patients by nurses at discharge is very
important in order to reduce the risk of complications and
also to identify any potential problems early. Patients
should be advised on the following:
ww Management of chest pain: This could be due to an
in-stent thrombosis or restenosis. The use of a glyceryl
trinitrate (GTN) spray should be discussed and, if the
chest pain has not resolved in 10 minutes, 999 should
be called
ww A patient experiencing chest pain who feels unwell
should call an ambulance, whether they have used
GTN or not
ww Medication: To continue with antiplatelet medication
without stopping. If there are concerns about bleeding
by other doctors, they should contact the patient’s
cardiologist before stopping aspirin or clopidogrel as the
risk of in-stent thrombosis is high without these drugs
ww Wound care: How to manage any bleeding (rest and
apply pressure for 10 minutes, if not stopped call 999),
have someone with them overnight, avoiding hot baths
and showers for a couple of days, and avoiding strenuous
lifting for 48 hours as this causes more pressure on the
artery leading to potential bleeding
ww Risk-factor modification
ww Driving: The patient can not drive for 1 week after
successful PCI. If the procedure was unsuccessful they
must stop driving for at least 4 weeks (Driver & Vehicle
Licensing Agency, 2013). If they have had a heart attack
this may be longer, but this depends on the clinical
circumstances.They should be provided with written information to
support the information given verbally