What is the most serious, life-threatening complication of AAA ...

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What is the most serious, life-threatening complication of AAA and why?
 
  What single problem mentioned at the beginning of this case study presents a risk for AAA
  rupture? Why?

Question 2

While A.H. awaits his surgery, it is important that you monitor him carefully for decreased tissue perfusion.
 
  Identify five things you would assess for, and state your rationale for each.

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Answer to Question 1

Rupture of the aneurysm: A ruptured aneurysm (as opposed to one with a slow leak) is usually rapidly fatal.

Risk for AAA rupture is evident in the statement, He hasn't had a bowel movement for 3 days.
Straining to have a bowel movement (Valsalva maneuver) can cause a profound increase in intraabdominal
pressure that could result in rupture.

Answer to Question 2

Urinary output: A decrease in kidney perfusion will result in decreased urine production.
Abdominal or lumbosacral pain: An increase in pain can mean enlargement of the aneurysm or
possible leakage.
Bowel sounds: Decreased or absent bowel sounds can indicate decreased perfusion of the
gastrointestinal (GI) tract.
Peripheral circulation: Decrease in pedal pulses, coolness, cyanosis, or mottling of the skin of the feet,
or increase in capillary refill time, indicates impaired peripheral circulation.
Chest pain: If perfusion of the myocardium is decreased, the heart can become ischemic.
VS: Hypotension, tachycardia, and tachypnea are signs of hypovolemia or hemorrhagic shock.
Level of consciousness (LOC): If cerebral perfusion is diminished, the patient might become confused
and anxious.

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