The Nurse Identifies a Collaborative Problem of Potential for Arterial

The nurse identifies a collaborative problem of potential for arterial trauma secondary to displacement of the balloon for a patient with an intraaortic balloon pump (IABP) . An appropriate action by the nurse for this problem is to

A) measure the patient's urinary output every hour.
B) keep the head of the bed elevated 30 to 45 degrees.
C) administer prophylactic heparin as ordered.
D) check the insertion site for bleeding every hour.