When preparing to assist with the insertion of a pulmonary artery catheter into a patient, the nurse will anticipate the need to perform which action?

A. Administer diuretics before the insertion: Diuretics reduce intravascular volume and are used in conditions such as fluid overload or heart failure. They are not routinely indicated prior to pulmonary artery catheter insertion and could potentially worsen hypotension. Pre-procedural management focuses on hemodynamic monitoring and rhythm surveillance. B. Apply a cardiac monitor prior to insertion: Insertion of a pulmonary artery catheter involves advancing the catheter through the right atrium and right ventricle into the pulmonary artery. Mechanical irritation of the myocardium can precipitate dysrhythmias, particularly ventricular ectopy. Continuous ECG monitoring allows immediate detection and prompt management of potentially life-threatening arrhythmias during the procedure. C. Check cardiac enzymes before insertion: Cardiac enzymes are measured to evaluate myocardial injury, such as in suspected acute coronary syndrome. While baseline labs may be obtained in critically ill patients, enzyme levels are not specifically required before catheter insertion. The priority concern is rhythm monitoring and hemodynamic stability. D. Auscultate heart sounds during insertion: Heart sound auscultation does not guide pulmonary artery catheter placement and is not useful for detecting catheter position. Correct positioning is determined by observing characteristic pressure waveforms as the catheter advances. Hemodynamic waveform monitoring provides real-time confirmation.