The intensive care unit (ICU) nurse educator will determine that ...

[renzo156]

The intensive care unit (ICU) nurse educator will determine that teaching about arterial pressure monitoring for a new staff nurse has been effective when the nurse
 
  a. balances and calibrates the monitoring equipment every 2 hours.
  b. positions the zero-reference stopcock line level with the phlebostatic axis.
  c. ensures that the patient is supine with the head of the bed flat for all readings.
  d. rechecks the location of the phlebostatic axis when changing the patient's position.

Question 2

When monitoring for the effectiveness of treatment for a patient with a large anterior wall myocardial infarction, the most important information for the nurse to obtain is
 
  a. central venous pressure (CVP).
  b. systemic vascular resistance (SVR).
  c. pulmonary vascular resistance (PVR).
  d. pulmonary artery wedge pressure (PAWP).

[nital]

Answer to Question 1

ANS: B
For accurate measurement of pressures, the zero-reference level should be at the phlebostatic axis. There is no need to rebalance and recalibrate monitoring equipment hourly. Accurate hemodynamic readings are possible with the patient's head raised to 45 degrees or in the prone position. The anatomic position of the phlebostatic axis does not change when patients are repositioned.

Answer to Question 2

ANS: D
PAWP reflects left ventricular end diastolic pressure (or left ventricular preload) and is a sensitive indicator of cardiac function. Because the patient is high risk for left ventricular failure, the PAWP must be monitored. An increase will indicate left ventricular failure. The other values would also provide useful information, but the most definitive measurement of changes in cardiac function is the PAWP.