Hemodynamic Complications

Question 1

What is catheter migration?

Answer 1

when the blood floats the catheter to a different location

Question 2

When is more common for the catheter to migrate?

Answer 2

when the balloon is inflated, which is why we never inflate it fan an extended period of time

Question 3

Where does the catheter go in forward migration?

Answer 3

into a capillary in the lungs and wedge itself

Question 4

What will you notice when there is catheter migration?

Answer 4

a change in waveform on the monitor

Question 5

What can forward migration cause?

Answer 5

pulmonary infarction

Question 6

What is present on a line to be able to pull back the catheter if needed?

Answer 6

sterile sleeve is present on the line

Question 7

Where the catheter go in does backward migration?

Answer 7

into the RV

Question 8

What can backward migration cause?

Answer 8

arrhythmias that can develop into V-Tach

Question 9

Can nurses reposition a Swan-Ganz catheter?

Answer 9

no

Question 10

What do you do if there is backward migration?

Answer 10

inflate the balloon

CALL Dr.

Question 11

Why should you inflate the balloon in backward migration?

Answer 11

the balloon is less irritating than the tip of the catheter, so less likely to cause arrhythmias

Question 12

What can over inflation (wedging of the balloon) cause?

Answer 12

pulmonary artery infarction

pulmonary artery rupture

Question 13

What do you do if there is pulmonary artery rupture?

Answer 13

turn patient IMMEDIATELY to the right

Question 14

What will happen to the pressure reading during over inflation?

Answer 14

part of the pressure reading is from the wedging

Question 15

What is the longest length in which wedging should occur?

Answer 15

no more than 30 seconds

Question 16

What will prolonged inflation cause?

Answer 16

pulmonary infarction

ischemic injury

Question 17

If a balloon ruptures and you attempt to wedge, what will you cause?

Answer 17

air embolus and parts of balloon may expel into the pulmonary

Question 18

If the balloon port is aspirated (though we should never aspirate it) and you aspirate fluid, what does that mean?

Answer 18

it has ruptured - (should be air-sealed)

Question 19

What increases risk of balloon rupture?

Answer 19

the more times it is inflated the more likely it is to rupture

Question 20

When should catheters typically be changed? And why?

Answer 20

after 7 days because chance of infection is 20% at 7 days

Question 21

What are the 3 pulmonary complications?

Answer 21

pneumothorax
pulmonary ischemia
pulmonary artery rupture

Question 22

What should you do if patient has a large heart and you are removing the catheter?

Answer 22

check x-ray beforehand to assess for knotting in central line

Question 23

What will cause valve damage?

Answer 23

if you pull an inflated balloon back across a closed valve