During insertion of a pulmonary artery catheter, the nurse watches the patient's cardiac monitor for changes in the waveform. As the nurse is assisting the provider with obtaining a wedge pressure, the nurse notes that the procedure has caused ventricular tachycardia. What the is the appropriate response?
a. Silence the alarm and alert the provider to withdraw the catheter
b. Alert the code team to respond to this life-threatening situation
c. Inflate the balloon to float the catheter back into the pulmonary artery
d. Place the patient on his side and flush the catheter with 10 mL of normal saline
c. Inflate the balloon to float the catheter back into the pulmonary artery
rationale: "Inflate the balloon to float the catheter back into the pulmonary artery" is correct. Insertion of a pulmonary artery catheter may stimulate the heart to produce occasional arrhythmias, which are not considered abnormal unless they are sustained. While advancing the pulmonary artery catheter, if the patient enters a state of ventricular tachycardia, the first action is to inflate the balloon port with 1.5 mL of air to attempt to "float" the catheter back into the pulmonary artery. If this does not work, the patient can be repositioned with the port still inflated in an attempt to return the catheter to the appropriate location. If the catheter is still malpositioned after these two interventions, the provider needs to be notified RIGHT AWAY, and they will attempt to advance the catheter or withdraw it completely.
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