The nurse is monitoring the PA pressure of a mechanically ventilated patient. In order to accurately measure this pressure, the nurse should obtain the measurement:
1. Whenever because the timing does not matter
2. At the last clear waveform before the baseline drops
3. At the last clear waveform before the baseline rises
4. With the patient off the ventilator
3
Rationale 1: Timing does matter because the measurement can be elevated because of the ventilator. Timing is crucial for accuracy.
Rationale 2: If it is measured before the baseline drops, this reading is high as the result of increased thoracic pressure in the chest from the positive pressure given by the ventilator.
Rationale 3: The positive pressure of the ventilator causes an abnormally high reading during inspiration. The accurate measurement is the reading seen before the baseline rises.
Rationale 4: Taking the patient off the ventilator is not an option.
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