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:
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