Which of the following are vessels that often require a surgical ...

[jake]

Which of the following are vessels that often require a surgical cut down when used for pulmo-nary artery catheter access? 1. Femoral vein 2. Subclavian vein 3. Internal jugular vein 4. Antecubital vein
 
  a. 1 and 2 only
  b. 1 and 4 only
  c. 2 and 4 only
  d. 2 and 3 only

Question 2

During the introduction of a pulmonary artery catheter the waveform seen in the figure is visible on the monitor. This waveform represents which of the following locations?
 
  a. Right atrium
  b. Right ventricle
  c. Pulmonary artery
  d. Pulmonary capillary

[amit]

Answer to Question 1

ANS: C
The subclavian, internal jugular, external jugular, femoral, or antecubital veins may be used for access for pulmonary artery catheters. A surgical cut down is often necessary when the subclavi-an or antecubital veins are used. This is done so that the vein may be visualized directly to facili-tate catheter entry. It is especially useful in cases of hypovolemic shock and trauma when periph-eral cannulation is difficult or impossible.

Answer to Question 2

ANS: A
This figure shows a pressure range of 2-6 mm Hg which is consistent with the right atrium. It also shows the characteristic respiratory fluctuations. The systolic pressure for the right ventricle is as high as 25 mm Hg, which is not seen in the figure. The systolic and diastolic ranges for pulmo-nary artery pressure are 15-35 and 5-15 mm Hg, respectively. This is higher than what is shown in the figure. Pulmonary capillary pressure when wedged is usually between 5 and 12 mm Hg, which is somewhat higher than what is shown in the figure.

[jake]

Thank you

[amit]

No problemo