Chapter 40: Nursing Management: Vascular Disorders Lewis et al.: Medical-Surgical Nursing in Canada, 3rd Edition | Questions and Answers with complete solution

1. A patient with a history of a 4-cm fusiform abdominal aortic aneurysm (AAA) is admitted to the emergency department with severe back pain and bilateral flank ecchymosis. His vital signs are blood pressure (BP) 90/58 mm Hg, pulse 138 beats/min, and respiration 34 breaths/min. The nurse plans interventions for the patient based on the expectation that which of the following treatments will be included? a. Immediate surgery b. An immediate angiogram c. A paracentesis when vital signs are stabilized with fluid replacement d. Admission to the intensive care unit for observation while diagnostic tests are completed - ANS: A The patient's history and clinical manifestations are consistent with rupture into the retroperitoneal space, and the patient will need immediate surgery to have a chance at survival. PTS: 1 DIF: Cognitive Level: Application REF: page 1008 OBJ: 2 TOP: Nursing Process: Planning MSC: CRNE: CH-13 2. A 69-year old man is admitted to the hospital for elective repair of an AAA. His history includes hypertension for 25 years, dyslipidemia for 15 years, and smoking for 50 years. The patient's wife asks the nurse what caused her husband's aneurysm. The nurse's best response will include which following information? a. A congenital weakness of an artery wall results in dilation of the artery after many years. b. Aneurysms are a type of vascular disease in which atherosclerotic plaques damage the artery. c. Chronic infections of the walls of the blood vessels are the most common cause of aneurysms. d. If her husband did not smoke or have hypertension and dyslipidemia, he would not have an aneurysm. - ANS: B The patient's gender, age, and risk factor history indicate that the aneurysm was probably caused by atherosclerosis rather than a congenital weakness or chronic infection.PTS: 1 DIF: Cognitive Level: Comprehension REF: page 1007 OBJ: 2 TOP: Nursing Process: Implementation MSC: CRNE: CH-8 3. A 65-year-old patient has a 5-cm thoracic aortic aneurysm that was discovered during a routine chest X-ray examination. When obtaining a nursing history from the patient, what would the nurse specifically ask the patient about? a. Abdominal pain b. Dysphagia c. Intermittent back pain d. Weakness and palpitations - ANS: B