AAA rupture

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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.

Questions like this are ridiculous for a test.

Well, yes and no. The specific question is not geared toward relevant nursing considerations. However, understanding the physiology of the immune response, cell response to injury, and the role of inflammation following injury is of particular importance.

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Specializes in Operating Room Nursing.

This really is a stupid question and annoys me. What are they thinking? Aren't they meant to be teaching critical thinking and how to prioritise?

As an OR nurse we're more concerned with dealing with keeping track of blood loss, keeping the suction going, opening up vascular trays, abdominal packs (usually end up with over 100 for these) and giving multiple transfusions than the white cell count. Immediate post surgical concerns are going to be blood pressure, leg pulses (sometimes they need an embolectomy or even amputation after) In fact, infection is the last thing we think of. With one of these we don't even wash our hands if it's bad enough we just put the gown and gloves if theres no time. And we don't have to count as it's a dire emergency, leaving a pack in is less important than getting that vascular clamp on the aorta in time to stop the bleeding. After this we can relax a bit while the graft is sewn in...

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Specializes in med/surg, telemetry, IV therapy, mgmt.
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.

the op also asked these questions on the student forums yesterday although quite differently. the question was first inserted into an older thread about f&e (https://allnurses.com/forums/f50/fluids-electrolytes-i-am-doomed-119516.html - fluids/electrolytes i am doomed!):

does anybody know what happens with wbc in the case of hypovalemic shock? do they increase or decrease??

i believe the wbc will decrease slightly, but not significantly because wbcs replenish themselves quickly and are always in a state of regeneration and never completely contained within the circulating blood. i found this information for the op:

they will decrease slightly, but not significantly. wbcs, either immature or mature, hang out and wait in various places throughout the body including the spleen, thymus gland, lymph nodes and tissues waiting to be called into service. neutrophils, the most common and numerous type of wbc, go into the circulating blood when mature but only live for 6 hours. they can be quickly replaced. monocytes only stay in the circulating blood for 70 hours and then they move into the body tissues where they become macrophages (page 1375,
davis's comprehensive handbook of laboratory and diagnostic tests with nursing implications
, 2nd edition, by anne m. van leeuwen, todd r. kranpitz and lynette smith). cell generation and maturation is an ongoing 24 hour/7 days a week process. if the wbc count is significantly decreased it is because of bone marrow failure (page 893,
mosby's diagnostic and laboratory test reference
, 4th edition, by kathleen deska pagana and timothy james pagana).

it was then that the business of the patient having had a ruptured aaa was brought up.

looking at this from another perspective, i was an iv therapist for many years and involved in all kinds of blood transfusion as well as a hospital supervisor. with hypovolemia (hemorrhage) packed rbcs are given. wbcs were only given to people who were low on wbcs: the cancer patients mostly. as a supervisor i can't tell you how many times i was running units of blood to the ors in the middle of the night for emergency aaa repairs that were going on.

it takes a lot for a person's body to be totally depleted of their wbcs. the little suckers come from the bone marrow as they are needed and begin the process to mature. it kicks up a few notches with the inflammation and immune reactions. the oncology nurses could probably tell you about the process a lot better.

according to the information i was finding, not all types of wbcs are in circulating blood at one time. in a hemorrhage situation the wbcs that happen to be in the blood that is lost at the time of hemorrhage are gone. that will be reflected in a cbc with a wbc count. however, within hours to a day or two, the wbc count is going to bounce back. first off, the aaa rupture will have triggered an inflammatory response sending a new force of neutrophils and macrophages into action. secondly, the surgical invasion, if there is one, will intensify this response. https://allnurses.com/forums/f50/histamine-effect-244836.html within a day, this person's wbc counts will probably be soaring despite the hypovolemia they had experienced.

now, i just need a doctor to confirm that i have the pathophysiology of this correct.

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Within a day, this person's WBC counts will probably be soaring despite the hypovolemia they had experienced.Now, I just need a doctor to confirm that I have the pathophysiology of this correct.

Not a doc, but I think you have it correct.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

more info about wbcs:

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