A nurse is caring for a post-operative patient after a mitral valve replacement. The nurse should monitor the patient's pulmonary capillary wedge pressure in order to:

Assess left ventricular end-diastolic pressure.

Explanation

• The mitral valve separates the left atrium from the left ventricle 

• The pulmonary capillary wedge pressure (PCWP) provides an indirect measure of the left ventricular end-diastolic pressure (left ventricular preload).  It is measured using a Swan-Ganz catheter inserted in a peripheral vein and ending in a branch of the pulmonary artery 

• Clinically, the PCWP is used to measure left ventricular failure or the severity of mitral valve stenosis. Both conditions would elevate left arterial pressure which would elevate the PCWP 

• When the PCWP is elevated, it is indicative of left ventricular heart failure 

• After a mitral valve replacement, there would be concern that the reduction of regurgitated flow back into the left atrium with each beat may impair left ventricular function 

• PCWP provides an indirect measurement for left atrial pressure (LAP).  It does not measure central venous pressure, right ventricular systolic pressure, or cardiac output. Of note, the Swan-Ganz catheter can measure cardiac output, but a different method is used 

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