The experienced nurse precepts a graduate nurse in the intensive care unit. Which action by the graduate nurse requires immediate intervention by the experienced nurse?

A pulmonary artery (PA) catheter, often called a Swan-Ganz catheter, is used to monitor hemodynamic status, including Pulmonary Artery Wedge Pressure (PAWP). The balloon at the tip of the catheter is extremely small and fragile. Improper inflation technique can lead to a pulmonary artery rupture, which is a life-threatening emergency with a high mortality rate. Rationale: A. Aligning the zero-reference stopcock with the phlebostatic axis: To ensure accurate hemodynamic pressure readings, the transducer's zero-reference stopcock must be leveled with the phlebostatic axis (the 4th intercostal space at the mid-axillary line, representing the position of the atria). B. Inflating the balloon on the pulmonary artery catheter using a new 10 mL syringe: The balloon on a PA catheter has a very small capacity, typically only 1.5 mL. Using a standard 10 mL syringe risks bursting the balloon or, more dangerously, rupture the pulmonary artery. Only the specialized, limited-volume syringe (usually 1.5 mL) provided by the manufacturer should ever be used. C. Obtaining an arterial blood sample from the right radial arterial line: Arterial lines are frequently used in the ICU to obtain accurate blood gas (ABG) samples and continuous blood pressure monitoring. As long as the nurse follows sterile technique and flushes the line afterward, this is safe. D. Administering intravenous furosemide through the distal lumen of the right subclavian central line: This is a correct action. Central venous catheters (CVCs) have multiple lumens. Although certain lumens are preferred for specific tasks (like CVP monitoring), the distal lumen is commonly used for the administration of high-volume fluids or medications because it opens into the largest part of the vein (the superior vena cava).