While caring for a patient with a pulmonary arterial catheter, the nurse notes that the number of centimeters of the catheter has decreased. Which of the following should be done at this time?
1. Report this finding immediately; the patient may need another chest x-ray to check for placement.
2. Flush the ports.
3. Zero balance the system.
4. Obtain a pulmonary artery occlusion pressure.
Report this finding immediately; the patient may need another chest x-ray to check for placement.
Rationale: The distance the catheter is inserted should be documented and serves as a reference to other care providers. If the length changes, the change should be reported immediately because it could mean that the catheter has advanced and could puncture a structure within the vasculature. The other choices would be inappropriate for the nurse to do at this time.
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