1a. What are the indications for the various hemodynamic monitoring methods (intra-arterial line) and the pulmonary artery pressure monitoring system?
Intra-arterial line procedures are the most efficient way to accurately asses the blood pressure of a patient without using any skin invasive measures. This method is the most appropriate to use especially for patient who cannot handle surgical procedures like those in critical procedures. Arterial lines not only help to correctly set the point of accurate blood pressure but also least risky when it comes to decreasing the probability of complications. Pulmonary pressure monitoring is mostly indicated for patients with critical conditions like assessing the right sided chamber fillings.
1b. What are the various ordered parameters used for in the case study?
The Mean Arterial Pressure (MAP) measures the necessary diastolic and systolic blood pressure necessary for adequate perfusion into the body. Central Venous Pressure [CVP] calculates blood pressure in the venacava into the right ventricle, while the pulmonary artery systolic [PAS] calculates systolic pressure in the pulmonary artery. PAWP measure the preload into the left ventricle. CO is used to measure how much blood the heart pumps at each beat. CA calculates the amount of blood from the left ventricle in relation to body surface area.
1c. What are the nursing responsibilities when caring for the patient with hemodynamic monitoring?
The nurse should make sure placements of equipment is accurate, and monitor readings such as the hemodynamic readings are normal. The nurse also provides necessary interventions in case problems arise.
1d. Of what potential complications should the nurse be aware when caring for the patient with hemodynamic monitoring?
Some risks that can arise during assessment include rapture of the pulmonary artery, knotting of the catheter, balloon rapture, pulmonary infarctions, deep vein thrombosis, dysrhythmias, and infection.
2a. What is the rationale for assessing distal pulses immediately after the catheterization?
These assessments are necessary to make sure that there are no clots. The absence of pulses indicate arterial occlusion.
2b. What other assessments should the nurse perform to check for arterial insufficiency?
The nurse checks for any sign of discoloration, the temperature, and capillary refill on the affected side by comparing it to the unaffected side. Check for sny signs of pain, tingliness, or numbness. Vital signs for the patient are monitored in intervals of 15 minutes per hour, thirty minutes per hour, and 1 hour per every four hours.
2c. The patient asks why he needs to stay in bed with the leg extended for 2 to 6 hours. How should the nurse respond?
The procedure the patient has undertaken is highly invasive and can cause complication like bleeding, occlusions and hematoma formation. Proper bedrest helps nurses monitor and prevent these problems.
2d. After the procedure, why is it important to assess the patient’s BUN, creatinine, and fluid volume status?
Patients who undergo this treatment procedure are liable to getting complications such as kidney failure. This complication is reversible through processes of dialysis.
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