A newly licensed cardiologist requested a clinical nurse specialist to assist in doing a right heart catheterization on a cyanotic patient. The cardiologist asks the nurse what should be used to inflate the balloon. The nurse should respond:
  1. Sterile normal saline
  2. Air
  3. CO2
  4. 50%-50%, saline and contrast
Explanation
Answer - C - The nurse should respond that CO2 should be used to inflate the balloon because CO2 is 20 times more soluble in blood than air. If the balloon breaks or leaks in the right heart, it will be more quickly absorbed. Since cyanotic shunts move across the septum in a R-L direction, some of the gas may pass through the R-L shunt. If it does embolize into the left heart, it might lead to a dangerous arterial embolism or stroke.
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