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You are monitoring a patient with a pulmonary artery catheter. You are
unable to measure the patient's pulmonary artery wedge pressure. To
obtain a value that corresponds to the pulmonary artery wedge pressure,
you check the:
A. Right ventricular pressure
B. Pulmonary artery diastolic pressure
C. Pulmonary artery mean pressure
D. Right atrial pressure - ✔✔B. Pulmonary artery diastolic pressure
When you cannot obtain a pulmonary artery wedge pressure, use the
pulmonary artery diastolic pressure to detect trends in the pulmonary artery
wedge pressure. The pulmonary artery diastolic pressure is usually 1 to 4
mm/Hg higher than pulmonary artery wedge pressure. However, a patient
with pulmonary disease has pulmonary artery diastolic pressure influenced
by higher right heart pressures, which do not correlate with the pulmonary
artery wedge pressure. (Recall that pulmonary artery wedge pressure is a
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, measure of left-sided heart pressure). The right atrial and right ventricular
pressures reflect right-sided, not left-sided, heart pressures. Use the
pulmonary artery mean pressure to calculate pulmonary vascular
resistance.
You are monitoring a patient's pulmonary artery catheter. The pulmonary
artery waveform spontaneously changes to a pulmonary artery wedge
pressure waveform. Choose the correct intervention:
A. Immediately pull the catheter back to the right atrium
B. Monitor the patient for ventricular ectopy
C. Inflate the balloon with 1.5 cc of air
D. Check that the balloon is fully deflated - ✔✔D. Check that the balloon is
fully deflated
Your patient's hemodynamic parameters are: Right atrial pressure of 4
mm/Hg; pulmonary artery wedge pressure of 7 mm/Hg; systemic vascular
resistance of 1,000 dynes/sec/cm-5; cardiac index of 3.5 L/minute; and left
ventricular stroke work index of 20 beats/minute. The heart function that
concerns you most is:
A. Contractility
B. Preload
C. Cardiac output
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