Exam 8: Hemodynamic Monitoring

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

The nurse is caring for a 70-kg patient in septic shock with a pulmonary artery catheter.Which hemodynamic value indicates an appropriate response to therapy aimed at enhancing oxygen delivery to the organs and tissues?

The physician orders a pulmonary artery occlusive (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.Nurse411.com.http://www.nurse411.com/Swan_Ganz.asp.Accessed April 2012.

The charge nurse is supervising the care of four critical care patients being monitored using invasive hemodynamic modalities.Which patient should the charge nurse evaluate first?

The nurse is caring for a patient with an admitting diagnosis of congestive 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 physician 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?

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.Prior to obtaining a cardiac output,which action is most important for the nurse to complete?

The nurse is caring for a mechanically ventilated patient being monitored with a left radial arterial line.During the inspiratory phase of ventilation,the nurse assesses a 20 mm Hg decrease in arterial blood pressure.What is the best interpretation of this finding by the nurse?

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?

Which of the following situations may result in a low cardiac output and low cardiac index? (Select all that apply.)

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

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 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?

Following insertion of a pulmonary artery catheter ( PAC ),the physician orders the nurse to obtain a blood sample for mixed venous oxygen saturation ( SvO₂ ).Which action by the nurse best ensures the obtained value is accurate?

The nurse is preparing to measure the thermodilution cardiac output (TdCO)in a patient being monitored with a pulmonary artery catheter.Which action by the nurse best ensures the safety of the patient?

The charge nurse has a Vigileo 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?

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 order?

The nurse is caring for a patient with a left radial arterial line,and a pulmonary artery catheter inserted into the right subclavian vein.Which action by the nurse best ensures the safety of the patient being monitored with invasive hemodynamic monitoring lines?

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?

When performing an initial pulmonary artery occlusion pressure (PAOP),what are the best nursing actions? (Select all that apply.)