Page 135 - AACN Essentials of Critical-Care Nursing Pocket Handbook, Second Edition

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Inject exact volume to correspond to computation constant. Carefully remove all air bubbles from syringe. Verify PA waveform from distal lumen. Pull catheter back. Advance catheter. Reposition patient. Rotate catheter to turn thermistor away

Action Do not turn stopcock to reestablish IV infusion through proximal

Troubleshooting Problems with Thermodilution Cardiac Output Measurements (continued)

Injectate volume less than designated amount Catheter too distal (PAW) RA port lies within sheath Thermistor against wall of PA Fibrin covering thermistor Incorrect variables Right-to-left shunt (VSD) Severe tricuspid regurgitation Incor

Cause

Problem Cardiac output values higher than expected

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