If a pulmonary artery catheter waveform fluctuates from 0 mmHg to 25 mmHg, what should the therapist do?

• A. Inflate the catheter balloon to sail the tip to the proper location
• B. Rotate the catheter to achieve a dicrotic notch in the waveform
• C. Suture the catheter in place
• D. Withdraw the catheter back to the upper vena cava

Answer: (A)

When a pulmonary artery catheter waveform displays significant fluctuations from 0 mmHg to 25 mmHg, it likely indicates that the catheter tip is in an inappropriate position, potentially in a large vessel or the right atrium rather than the pulmonary artery. The correct action in this scenario is to inflate the catheter balloon to enable the clinician to advance the catheter tip into the correct position, which is typically within the pulmonary artery.

Inflating the balloon allows the catheter to "sail" into the pulmonary artery, where it can obtain accurate pressure readings and facilitate proper monitoring of pulmonary hemodynamics. This maneuver is crucial, as accurate positioning of the catheter is essential for proper function and therapeutic application.

Options involving rotating the catheter or suturing it in place would not resolve the issue of incorrect placement and could lead to further complications or erroneous readings. Withdrawing the catheter back to the upper vena cava may not address the underlying issue of fluctuating pressure readings, as it may still remain in a position that is not optimal for effective monitoring. Thus, inflating the balloon provides the best approach to correctly situate the catheter tip.