The nurse observes that a patient being monitored with a pulmonary artery catheter has a missing c wave. Which of the following does this finding suggest?
1. It is difficult to determine the pulmonary artery occlusion pressure.
2. Nothing, because this wave is often missing from view.
3. It should appear at the end of the QRS complex.
4. It should appear simultaneously with the T-P interval of the ECG.
It is difficult to determine the pulmonary artery occlusion pressure.
Rationale: Identification of the c wave on a pulmonary artery catheter tracing is important because prior to the c wave occurring, the pressure equilibrates between the atrium and the ventricle. If the c wave is missing, the pulmonary artery occlusion pressure is obtained by averaging the a wave and x wave. The c wave is often missing with a central venous pressure monitor tracing. The a wave appears near the end of the QRS complex. The v wave appears simultaneously with the T-P interval of the ECG.
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