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

Question

What is the best action by the nurse? a. Limit the patient's supine position to no more than 10 seconds.
b. Administer anxiety medications while recording the pressure.
c. Encourage the patient to take slow deep breaths while supine.
d. Elevate the head of the bed 45 degrees while recording pressures.

Answer 1

D
Hemodynamic parameters can be accurately measured and trended with the head of the bed elevated to 45 degrees as long as the zeroing stopcock is properly leveled to the phlebostatic axis. Elevating the head of the bed to 45 degrees would be the optimum position to obtain a pulmonary artery occlusion pressure for a patient that becomes anxious and tachypneic when flat. Administering anxiety medications is not standard of care for obtaining hemodynamic pressures. Encouraging slow deep breaths while supine may inappropriately alter hemodynamic readings by altering intrathoracic pressure.