Which of these approaches would be most appropriate for the nurse to take when preparing a patient with a Swan-Ganz catheter for a hemodynamic assessment?
1. placing the patient in Trendelenburg position prior to obtaining measurements
2. injecting cardiac output fluid at the beginning of inspiration
3. zeroing the transducer at the phlebostatic axis
4. warming cardiac output injectate fluid to body temperature
3
Rationale: The phlebostatic axis approximates the level of the right atrium and is considered to represent the level of the catheter tip. Trendelenburg position or the head down position may be used during insertion of the catheter to make visualization of the jugular approach easier. However, supine is the recommended position for hemodynamic readings. Cardiac output injected is inserted at end expiration. Injectate should be iced or room temperature but not warmed.
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