The nurse is preparing to obtain a pulmonary artery occlusion pressure (PAOP) reading for a patient who is mechanically ventilated. Ensuring that the air-fluid interface is at the level of the phlebostatic axis, what is the best nursing action?
a. Place the patient in the supine position and record the PAOP immediately after exhalation.
b. Place the patient in the supine position and document the average PAOP obtained after three measurements.
c. Place the patient with the head of bed elevated 30 degrees and document the average PAOP pressure obtained.
d. Place the patient with the head of bed elevated 30 degrees and record the PAOP just before the increase in pressures during inhalation.
D
Pressures are highest when measured at end exhalation in the spontaneously breathing patient. In mechanically ventilated patients, pressures increase with inhalation and decrease with exhalation. Measurements are obtained just before the increase in pressure during inhalation. Supine positioning is contraindicated in the mechanically ventilated patient. The head of bed should be elevated to 30 degrees. Pulmonary artery occlusion pressure is not averaged, but measured during inhalation in the mechanically ventilated patient while appropriate positioning is maintained.
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