The nurse is preparing to obtain a right atrial pressure (RAP/CVP) reading. What are the most appropriate nursing actions? (Select all that apply.)
a. Compare measured pressures with other physiological parameters.
b. Flush the central venous catheter with 20 mL of sterile saline.
c. Inflate the balloon with 3 mL of air and record the pressure tracing.
d. Obtain the right atrial pressure measurement during end exhalation.
e. Zero reference the transducer system at the level of the phlebostatic axis.
A, D, E
To obtain an accurate right atrial pressure (RAP/CVP) reading, the transducer system should be zero referenced and leveled with the phlebostatic axis to ensure accurate readings; the value should be obtained during end exhalation, and any obtained measure should be evaluated in light of the patient's physiological parameters and physical assessment. The catheter does not need to be flushed before measurement because continuous saline flush is part of the RAP system. There is no balloon with a right atrial pressure (RAP/CVP) catheter.
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