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Author Question: The resection of A.H.'s aneurysm is successful, but for the first 3 postoperative days he is ... (Read 70 times)

strangeaffliction

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on: Jun 25, 2018
The resection of A.H.'s aneurysm is successful, but for the first 3 postoperative days he is delirious and requires one-to-one nursing care before he becomes coherent and oriented again. He is transferred back to your floor.
 
  What assessments should be made that are specific to his postoperative care?

Question 2

During your assessment you notice a pulsation in A.H.'s upper abdomen, slightly left of the midline, between the umbilicus and the xiphoid process.
 
  True or False: You will need to palpate this mass as part of your physical assessment. Explain your answer.


cswans24

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Reply #1 on: Jun 25, 2018
Answer to Question 1

 Check pulses distal to the aneurysm to make certain the graft has not clotted off. In addition, check
the temperature of the extremities below the graft.
 Maintain his BP within the range specified by the surgeon to (1) allow the clot to form on the inside
of the graft and (2) ensure that the graft does not separate as a result of high BP.
 Continuous cardiac monitoring will be done to watch for any dysrhythmias.
 Monitor intake and output every 8 hours; blood urea nitrogen (BUN) and creatinine levels, and
daily weights to observe for any fluid retention and monitor renal function.
 Monitor for other signs of graft occlusion, such as severe pain, abdominal distention, and white or
blue extremities or flank.

Answer to Question 2

False. If a pulsating abdominal mass is noted, you might gently auscultate it for a bruit, but do not
palpate the mass It might be tender, but more important, there is a risk of rupture of the aneurysm
with palpation.


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strangeaffliction

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Reply #2 on: Jun 25, 2018
Correct answers!


cswans24

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Reply #3 on: Jun 25, 2018
Great! Please up vote :D


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