The nurse is caring for a patient who has an intraortic balloon pump (IABP) following a massive heart attack. When assessing the patient, the nurse notices blood backing up into the IABP catheter
In which order should the nurse take the following actions? (Put a comma and a space between each answer choice [A, B, C, D].)
a. Ensure that the IABP console has turned off.
b. Assess the patient's vital signs and orientation.
c. Obtain supplies for insertion of a new IABP catheter.
d. Notify the health care provider of the IABP malfunction.
ANS:
A, B, D, C
Blood in the IABP catheter indicates a possible tear in the balloon. The console will shut off automatically to prevent complications such as air embolism. Next, the nurse will assess the patient and communicate with the health care provider about the patient's assessment and the IABP problem. Finally, supplies for insertion of a new IABP catheter may be needed, based on the patient assessment and the decision of the health care provider.
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