Nursing care of abdominal aortic aneurysm

[allioop4]

If I had a patient with an abdominal aortic aneurysm that was scheduled for a repair but suddenly had worsening abdominal pain and flank pain, would I assess vital signs first or notify the doc? I know it's an emergency, but do we ALWAYS assess first?

[nurseprnRN, BSN, RN]

If you have someone with a known abdominal aortic aneurysm who's going to have it surgically repaired tomorrow, and all of a sudden develops new and sudden pain, what do you think is going on? That's your first thought. Hint: It is probably not the tacos he had for lunch yesterday.

While you're considering that, you are reaching for the BP cuff (not leaving the room to go find one, for gawdsakes), assessing his belly for increase in size, calming him, and calling for someone to call the surgeon and the OR, because sure as god made little green apples this man is dissecting his aneurysm some more and may be about ready to bleed to death in five minutes right in front of you. Yeah, you want to keep him pain free and calm, but those can take second position to "alive."

[Anoetos, BSN, RN]

Per Kaplan, in NCLEX-land, if you have enough assessment information and especially if the situation is emergent, you contact the doc.

You don't assess if you have enough information. In this case, if the Dx is AA these signs would be enough for me to call the doc. (I'd probably be collecting vital signs as I did so, but there may not be time for a lab draw). In such cases, the answer to assess further is wrong.

Let us know what you find out.