A client with an aortic aneurysm is about to undergo surgery for repair of the aorta. Prior to surgery, the nurse should instruct the client to:
1. Hold her breath when defecating.
2. Keep her legs flat when in bed.
3. Report a headache to the nurse.
4. Continue taking anticoagulants.
Answer: 2
1. The client should be instructed not to hold the breath when defecating, because it increases abdominal pressure, which could cause the aneurysm to rupture.
2. The legs are kept flat because, if they were elevated, it could increase blood flow and put pressure on the aneurysm.
3. The client should be taught to report increased lumbar, abdominal, or groin pain, as it could be an indication of rupture.
4. Anticoagulants are not administered to a client prior to surgery, because of the risk of bleeding.
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