Under what circumstance would the nurse expect to prepare a patient for surgery when abdominal trauma has occurred? A patient with:
1. A suspected splenic injury and who has received 1 unit of blood
2. A Grade III liver injury with stable vital signs
3. A contusion to the kidney with a stable H & H
4. A pelvic fracture with muscle rigidity of the abdominal wall
4
Rationale 1: If additional bleeding requires more than 2 units of blood or becomes unstable, the patient with splenic injury will require surgical repair to stop the bleeding.
Rationale 2: In a Grade III liver injury, conservative management outweighs the risks of surgery. If a Grade IV or V injury occurs in the liver, then surgical repair is called for immediately.
Rationale 3: With a contusion to the kidney bedrest and careful assessment of renal status is enough for the contusion to resolve with time.
Rationale 4: The patient with a pelvic fracture is exhibiting signs of bladder rupture by the muscle rigidity. Immediate surgery is required to assess and repair the damage to internal organs.
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