Question

A nurse is caring for a patient with a central venous pressure (CVP) catheter.

• What are the key nursing responsibilities of managing a CVP catheter?
• What position must the nurse place the patient to read the CVP correctly?

A cardiac patient has recently been diagnosed with heart failure.

• Define clinical manifestations of left-sided failure and right-sided failure

What is different in the actions of ACE inhibitors and beta-blockers with relation to heart failure?

• The nurse is admitting a patient with hypertension. Upon assessment, the patient’s blood pressure is 180/110 mm Hg.
• What are the potential complications that can occur with sustained elevated blood pressure?

Answer 1

Ans) Key nursing responsibilities of managing a CVP catheter:

- Assist MD/HCP with insertion

- Confirm placement before using catheter

- Assessment and maintenance is RN responsibility

- Maintain patency

- Maintain sterile technique

- Apply dressing and cap changes per protocol

- Administer IV fluids & medications

.- Prevent complications - infection

ALWAYS PER HOSPITAL PROTOCOL

- dressing q 7 days

Position must the nurse place the patient to read the CVP correctly:

- The CVP can be measured either manually using a manometer or electronically using a transducer. In either case the CVP must be 'zeroed' at the level of the right atrium. This is usually taken to be the level of the 4th intercostal space in the mid-axillary line while the patient is lying supine.

Left-sided heart failure clinical manifestation include:

Awakening at night with shortness of breath. Shortness of breath during exercise or when lying flat. Chronic coughing or wheezing.

Clinical manifestation of Right Sided Heart Failure:
Shortness of breath during exercise or when lying flat. Coughing. Wheezing. Difficulty concentrating.

Angiotensin-converting enzyme (ACE) inhibitors are very important medicines for managing heart failure. They relax blood vessels and lower blood pressure. This improves blood flow. Your heart is then able to pump more blood to the rest of your body without working harder.

Beta-blockers help treat diastolic heart failure, because they slow the heart rate and allow more time for your heart to fill with blood. This allows the left ventricle to fill more completely and increases the volume of blood that the heart pumps with each heartbeat (ejection fraction).