A patient with congestive heart failure is receiving scheduled doses of intravenous Bumex. After administering the drug, which finding would indicate to the nurse that the drug was effective?
1. a pulmonary artery wedge pressure of 16 mm Hg
2. a right atrial pressure of 5 mm Hg
3. a systemic vascular resistance of 1,400 dynes/sec/cm-5
4. a pulmonary artery pressure of 34/16
2
Rationale: Bumex is a loop diuretic whose purpose is to reduce preload and right atrial pressure. A right atrial pressure of 5 is a normal reading. A normal pulmonary arterial wedge pressure is 4 to 12; 16 is high and would indicate high preload. Normal systemic vascular resistance is 800 to 1,200 dynes/sec/cm-5. With diuretic use, the systemic vascular resistance should also normalize. Normal pulmonary artery pressure is 20 to 30/8 to 15. These pressures should also decrease with diuretic administration.
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