The cardiovascular clinical nurse specialist as case manager during endovascular revascularization of renal artery stenosis.

The management of renovascular hypertension includes recent advances in detection, evaluation and treatment. Patients with confirmed renovascular hypertension require coordination of their care during the diagnostic and interventional phases of treatment. Renal artery angioplasty is often the selected intervention for renovascular hypertension Nurses caring for patients during the periprocedural period are challenged to provide preadmission instructions that often involve medication adjustments, information related to angioplasty, and discharge instructions that address vascular access site care and renovascular care. Comprehensive nursing care extends from the outpatient diagnostic phase, through the acute hospital phase and concludes with outpatient follow-up and telephone consultation. Case management during these relatively short episodes of care expedites care delivery, minimizes duplication of services, and involves patients as active participants. This study applies a case management model to a patient with renal artery stenosis treated with angioplasty and stent placement. The value of collaborative, clinical nurse specialist-coordinated care and patient education is emphasized.