Exam 8: Hemodynamic Monitoring

While caring for a patient with a pulmonary artery catheter,the nurse notes the pulmonary artery occlusion pressure (PAOP)to be significantly higher than previously recorded values.The nurse assesses respirations to be unlabored at 16 breaths/min,oxygen saturation of 98% on 3 L of oxygen via nasal cannula,and lungs clear to auscultation bilaterally.What is the priority nursing action?

The provider prescribes a pulmonary artery occlusive pressure reading (PAOP)for a patient being monitored with a pulmonary artery catheter.Immediately after obtaining an occlusive pressure,the nurse notes the change in waveform indicated on the strip below.What are the best actions by the nurse? Figure from Geiter H, Jr.: Swan-Ganz Catheters. http://www.nurse411.com. Accessed April 2012.

The nurse is preparing for insertion of a pulmonary artery catheter ( PAC ). During insertion of the catheter,what are the priority nursing actions? (Select all that apply.)

The provider writes an order to discontinue a patient's left radial arterial line.When discontinuing the patient's invasive line,what is the priority nursing action?

During insertion of a pulmonary artery catheter,the provider asks the nurse to assist by inflating the balloon with 1.5 mL of air.As the provider advances the catheter,the nurse notices premature ventricular contractions on the monitor.What is the best action by the nurse?

The nurse is caring for a mechanically ventilated patient with a pulmonary artery catheter who is receiving continuous enteral tube feedings.When obtaining continuous hemodynamic monitoring measurements,what is the best nursing action?

The charge nurse is supervising care for a group of patients monitored with a variety of invasive hemodynamic devices.Which patient should the charge nurse evaluate first?

The nurse is caring for a patient with a left subclavian central venous catheter ( CVC )and a left radial arterial line.Which assessment finding by the nurse requires immediate action?

The nurse is caring for a patient with a pulmonary artery catheter.Assessment findings include a blood pressure of 85/40 mm Hg,heart rate of 125 beats/min,respiratory rate 35 breaths/min,and arterial oxygen saturation (SpO₂)of 90% on a 50% Venturi mask.Hemodynamic values include a cardiac output (CO)of 1.0 L/min,central venous pressure (CVP)of 1 mm Hg,and a pulmonary artery occlusion pressure (PAOP)of 3 mm Hg.The nurse questions which of the following physician's orders?

Upon entering the room of a patient with a right radial arterial line,the nurse assesses the waveform to be slightly dampened and notices blood to be backed up into the pressure tubing.What is the best action by the nurse?

The nurse is caring for a patient with an admitting diagnosis of congestive heart failure.While attempting to obtain a pulmonary artery occlusion pressure in the supine position,the patient becomes anxious and tachypneic.What is the best action by the nurse?

The nurse is caring for a patient following insertion of a left subclavian central venous catheter ( CVC ).Which assessment finding 2 hours after insertion by the nurse warrants immediate action?

The charge nurse has a pulse contour cardiac output monitoring system available for use in the surgical intensive care unit.For which patient is use of this device most appropriate?

While inflating the balloon of a pulmonary artery catheter ( PAC )with 1.0 mL of air to obtain a pulmonary artery occlusion pressure ( PAOP ),the nurse encounters resistance.What is the best nursing action?

The nurse is preparing to obtain a pulmonary artery occlusion pressure (PAOP)reading for a patient who is mechanically ventilated.Ensuring that the air-fluid interface is at the level of the phlebostatic axis,what is the best nursing action?

Which nursing actions are most important for a patient with a right radial arterial line? (Select all that apply.)

The nurse is educating a patient's family member about a pulmonary artery catheter ( PAC ).Which statement by the family member best indicates understanding of the purpose of the PAC?

The nurse returns from the cardiac catheterization laboratory with a patient following insertion of a pulmonary artery catheter and assists in transferring the patient from the stretcher to the bed.Before obtaining a cardiac output,which action is most important for the nurse to complete?

The nurse is caring for a patient with an arterial monitoring system.The nurse assesses the patient's noninvasive cuff blood pressure to be 70/40 mm Hg.The arterial blood pressure measurement via an intraarterial catheter in the same arm is assessed by the nurse to be 108/70 mm Hg.What is the best action by the nurse?

While caring for a patient with a small bowel obstruction,the nurse assesses a pulmonary artery occlusion pressure (PAOP)of 1 mm Hg and hourly urine output of 5 mL.The nurse anticipates which therapeutic intervention?