NAME__________________________POSITION ____________ UNIT ___________

EVALUATOR___________________ POSITION ____________ UNIT ____________


Critical Performance Elements

Yes No
COMPETENCY STATEMENT: Provides nursing care for the patient requiring pulmonary artery pressure monitoring and cardiac output determinations.    
1. Identifies the indications for PA monitoring.    
2. Assembles necessary equipment for insertion of a PA line.    
3. Assists physician with the insertion procedure.    
4. Ensures that a stat chest x-ray is performed and interpreted after catheter insertion.    
5. Positions the patient supine or with head of bed elevated to measure PA pressures. Places the air-fluid interface of the transducer system at the phlebostatic axis.    
6. Levels and zeros the transducer to atmospheric pressure at least every 4 hours and with position changes.    
7. States the proper usage of each catheter lumen.    
8. Identifies the appropriate right atrial (CVP) and PA waveforms and their values.    
9. Identifies the pulmonary capillary wedge (PCW) waveform and obtains a PCWP as ordered, using a maximum of 1.5 cc of air to inflate the balloon.    
10. Measures all pressures at end of expiration.    
11. Obtains cardiac outputs/indices as ordered and evaluates the systemic vascular resistance (SVR) with each cardiac output.    
12. Notes measurement trends, states the potential causes of abnormal readings, and correlates the information to the patient’s condition.    
13. Identifies inappropriate waveforms and troubleshoots as necessary.    
14. Changes the IV and flush solutions, tubing, and dressing IAW Infection Control Manual. Inspects for signs of infection.    
15. Obtains mixed venous blood sample. (verbalized)    
16. Prepares for removal of pulmonary artery catheter.    
17. Documents all pertinent information    


This page last updated 07/25/10

All comments and questions about content at this site should be sent to Nurse Bob