Following insertion of a pulmonary artery catheter (PAC), the physician orders the nurse to obtain a blood sample for mixed venous oxygen saturation (SvO2). Which action by the nurse best ensures the obtained value is accurate?
a. Zero referencing the transducer at the level of the phlebostatic axis following insertion
b. Calibrating the system with a central venous blood sample and arterial blood gas value
c. Ensuring patency of the catheter using a 0.9% normal saline solution pressurized at 300 mm Hg
d. Using noncompliant pressure tubing that is no longer than 36 to 48 inches and has minimal stopcocks
B
To ensure that an accurate SvO2 is obtained, calibration of the invasive monitoring system (e.g., PAC) is accomplished upon insertion and requires both a central venous blood sample from the PAC and an arterial blood gas sample. This process is unique to the accuracy of venous oxygen saturation monitoring systems. Zero referencing the transducer at the level of the phlebostatic axis, ensuring patency of the catheter with a pressurized flush system, and using tubing of adequate length ensure accuracy of all hemodynamic monitoring systems.
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