Author Question: A client with a known abdominal aortic aneurysm reports dizziness and severe abdominal pain. The ... (Read 119 times)

bclement10

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A client with a known abdominal aortic aneurysm reports dizziness and severe abdominal pain. The nurse assesses the client's blood pressure at 82/40 mm Hg. What actions by the nurse are most important? (Select all that apply.)
 
  a. Administer pain medication.
  b. Assess distal pulses every 10 minutes.
  c. Have the client sign a surgical consent.
  d. Notify the Rapid Response Team.
  e. Take vital signs every 10 minutes.v

Question 2

A client has peripheral arterial disease (PAD). What statement by the client indicates misunderstanding about self-management activities?
 
  a. I can use a heating pad on my legs if it's set on low.
  b. I should not cross my legs when sitting or lying down.
  c. I will go out and buy some warm, heavy socks to wear.
  d. It's going to be really hard but I will stop smoking.



janeli

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Answer to Question 1

ANS: B, D, E
This client may have a ruptured/rupturing aneurysm. The nurse should notify the Rapid Response team and perform frequent client assessments. Giving pain medication will lower the client's blood pressure even further. The nurse cannot have the client sign a consent until the physician has explained the procedure.

Answer to Question 2

ANS: A
Clients with PAD should never use heating pads as skin sensitivity is diminished and burns can result. The other statements show good understanding of self-management.



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