You are working on a telemetry unit and have just received a transfer from the ICu. The 50-year-old male
patient, T.A., is postoperative day 2 after a repair of an abdominal aortic aneurysm (AAA) measuring 8 cm
in diameter.
He is an attorney with an active practice. Before surgery, he routinely took medication for
gastritis and has a 10-year history of type 2 diabetes mellitus requiring insulin for the past 6 months to
control glucose levels. Despite this, T.A. considered himself healthy before diagnosis of the aneurysm. The
ICu nurse tells you during the report that since surgery, T.A. has experienced some weakness of his lower
extremities and decreasing urinary output.
T.A. has questions about his surgery. He asks you, "I was fine before surgery. I'd still be fine
now if I hadn't been operated on, wouldn't I?" Based on your knowledge of AAA, what will
your response be?
No. Because of the size of his aneurysm, he was at great risk for rupture. Although aneurysms less
than 6 cm in diameter can be managed medically, those greater than 6 cm should be surgically
repaired because the risk for rupture and subsequent mortality is extremely high. Aneurysms
typically grow at 0.5 cm per year. Therefore, T.A. was not fine before the surgery; he was at high risk
for sudden death and did not know it.
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A patient is postoperative day 3 following major bowel surgery and has been reluctant to ambulate since being admitted from postanesthetic recovery 2 days ago
As a result, the patient has developed atelectasis and is now being treated for this problem. When administering the patient's bronchodilator by nebulizer, what teaching should the nurse provide? A) "If possible, take slow, deep breaths while your nebulizer is running." B) "Try to avoid coughing until your nebulizer has finished." C) "If you can practice 'huffing' while your nebulizer is running, it will help the medication reach your lungs." D) "Try to breathe through your nose to ensure that you get as much benefit as possible from your medication."
When measuring the size, depth, and wound tunneling of a client's stage IV pressure ulcer, what action should the nurse perform first?
A) Perform hand hygiene. B) Insert a swab into the wound at 90 degrees. C) Measure the width of the wound with a disposable ruler. D) Assess the condition of the visible wound bed.
The American Academy of Pediatrics suggests that caregivers do which of the following things in regard to physical activities for preschoolers?
a. Encourage a variety of physical activities in a noncompetitive environment. b. Keep physical activities to a minimum until the child is in grade school. c. Have the child engage in competitive sports to see there they excel. d. Push the child to practice sports activities while they are more flexible.
Which intervention will best assess a narcoleptic patient for a commonly recognized comorbid psychiatric disorder?
a. Observing for signs of self-mutilation b. Observing the patient for ritualistic behaviors c. Asking, "Do you consider yourself to be depressed?" d. Asking, "Do you rely on alcohol to function socially?"