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Discussion

AAA rupture

I need HELP! If a pt has a AAA that ruptures will their WBC level be increased OR decreased?? Thank you so much to anybody that can answer this! I really appreciate it.

Featured Replies

Well, if they live long enough to care about their WBC, then you could expect it to elevate. I think you could do a little research to find out why.

  • Author

I appreciate the response. There is nothing in my text books regarding WBC related to hypovalemic shock and online I just saw that they are increased when an infection is present.

Ok, well you need to do a little more research into the immune system and the immune response. There is more than hypovolemic shock going on. Assuming the patient survives the initial rupture and his problem is repaired, you question is more relevant in the post surgical setting.

With that in mind, does the WBC only increase in response to infection? Is the WBC even a specific finding for much of anything? Are there specific components to the WBC?

  • Author

That actual question was this:

How do you know that a pt has an AAA that has ruptured?

The correct answers where: decreased BP, pain, decreased H&H

Then we had to choose between decreased WBC or increased WBC.

I understand the question; however, I am challenging you to turn this into a learning experience. You gain nothing by reading "this is the answer," do some research and find out why. This will help you better understand the answer.

  • Author

Ok, is the WBC increased in relation to the heart failing? Trust me. I have been looking into this question for days. Apparently there is something that i'm just not getting. I know that WBC increase in relation to an MI.

That actual question was this:

How do you know that a pt has an AAA that has ruptured?

The correct answers where: decreased BP, pain, decreased H&H

Then we had to choose between decreased WBC or increased WBC.

Answer: When the pt codes its usually meant that their AAA has ruptured.:eek:

Well, if they live long enough to care about their WBC, then you could expect it to elevate. QUOTE]

:loveya:

exactly what i was thinking-

Well, if they live long enough to care about their WBC, then you could expect it to elevate. I think you could do a little research to find out why.

:D I was thinking, if a pt has a ruptured AAA, who the he** cares about the WBC? I should have known it was a nursing school question!

The sad truth is most people with this condition do not live long enough to worry about WBCs.

  • Author

I'm starting to think I never should have posted this question. As this is only making me more frustrated! Ughhh!

  • Experts

DMBFAN, I don't think it's anyone's intent to frustrate you here. We have all been to nursing school and had those things that took us a while to 'get.' What I am getting from this thread is:

a) we know this has to be a question from nursing school because there is no way in the real world anyone would worry about WBC in the heat of a ruptured AAA. That's not meant as a knock to you. It's just that in nursing school and in the NCLEX-utopia, there is always enough time to figure out every last minute detail, and always enough staff to do everything needed in time. Frankly, when I read your question, I thought to myself, who flippin cares what the WBCs are doing when a vessel the size of a garden hose is ruptured and bleeding out internally??? Again, that's not an attack on you, nor the fact that you asked questions. That's just a statement of fact - ruptured AAA's are very rarely survived.

b) The other thing I'm seeing is that feeling that I remember oh-so-well from nursing school. That feeling that, no matter how much you think about it, you're never going to understand. But you will....you may need to step away from your books for a few minutes so you can come back and think clearly. You may need to draw yourself diagram after diagram, or talk to yourself til you figure out the pathophysiology. It will, however, benefit you in the long run to figure out why something is the way it is or does what it does, rather than have someone tell you the answer and you memorize it. Nobody's trying to antagonize you here, believe me.

Now, if you want to throw out some theories, that would be awesome for discussion.

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