What should the nurse do first when a patient cannot palpate a pedal pulse following cardiac catheterization?

When a patient cannot palpate a pedal pulse following cardiac catheterization, the priority action is to recheck the pedal pulse using a Doppler. This approach is crucial because the absence of a palpable pulse can indicate compromised blood flow to the extremities, which is a potential sign of a serious post-procedural complication such as arterial occlusion or hematoma. Utilizing a Doppler device allows the nurse to accurately assess the presence of vascular flow that may not be detectable by palpation alone.

By confirming the presence or absence of a Doppler signal, the nurse can gather essential information regarding the vascular status of the patient's limb. If blood flow is indeed absent, it would necessitate prompt further evaluation and intervention, such as notifying the physician or implementing appropriate care measures to address potential complications.

It is important to recognize that assessing capillary refill and positioning the patient in Trendelenburg are valuable actions but secondary to directly verifying blood flow with a Doppler. Notifying the physician may be necessary depending on the findings from the Doppler assessment, but addressing the immediate concern of blood flow is the priority.