Test question - how would you answer?

memphispanda, RN · Sep 22, 2003

I would pick B blood pressure monitoring. The patient would be at a pretty high risk for additional internal bleeding, the repair could begin to ooze or rupture, etc.

deadend · Sep 22, 2003

that's tough I'm stuck between 2 and 1 but I would choose 2 because I believe and abdominal anuerysm is painful. The pt will have a surgical dressing dreesing on in the 1st 24 hours

RN 2005 · Sep 22, 2003

I am first semester student so I have no real idea but I will hazard a guess..........

I would think BP monitoring.

MQ Edna · Sep 22, 2003

I'm going to say pain management because pain can make the blood pressure rise and you don't want to stress the wall of the aorta.

Kathy

Ortho_RN · Sep 22, 2003

Im gonna say Pain Management also.. but if I had this question on a test I would probably change it several times :) from 1 to 2 and back and forth

EastCoast · Sep 22, 2003

I would say 2.

the b/p is going to be an indicator of pain control, anxiety and bleeding as well as potential rupture of the repair. (i would have added b/p and pulse as an test answer as strictly looking at b/p alone can be misleading. )

wound assessment crucial but as poster previous said original dressing in place so unless significant drainage might not be first sign of a problem.

pain of course ( and given all the talk of the 5th vital sign i wouldn't be surprised if this was the answer the professor wanted). not the most pressing to me under the circumstances but would be worrisome if patient developed sharp, stabbing pain. you get the idea.

so , i think there are a few different ways of looking at it and not all are necessarily wrong.

hope you did well.

LauraLou · Sep 22, 2003

I would answer 2 - Blood pressure monitoring. I used my "would it kill the patient?" reasoning.

If the patient is in pain, it isn't good, but it won't kill him.

The surgical dressing won't be changed in the first 24 hrs, so this answer should be eliminated.

If the patient isn't on his feet within 24 hours, it won't kill him.

If the patient is bleeding internally, this can kill him. Thus monitoring blood pressure is the most important priority.

Perhaps not the most elegant reasoning process, but it helps me keep the priorities straight.

Carolanne · Sep 22, 2003

I vote for pain management. In our med-surg course last semester, they really stressed pain management. Pain can make the BP rise and cause more distress to the patient, so I remember being drilled about getting the pain under control first.

EastCoast · Sep 22, 2003

lauralou,,,,

my reasoning exactly.

pain still just equals pain unless it is rupture of repair...it should be part of the routine assessment and it is expected.

rupture graft=blood loss=hypotension=get them back to the OR or =never have pain again.

the problem still lies in that this is a test. we all know that the 'right answer' is not the most logical it may just be the buzz word.

BamaGirlRN · Sep 23, 2003

B-B/P...I think that is what they are looking for.

det01 · Sep 23, 2003

I would say wound assessment...based on the risk that surgery patients are at for infection.

I know it shouldn't be chaged the first 24 hours...but they may say they want you to check the bandage and make sure it isn't bleeding through...it may not be a "real world" best answer but in my limited experience they trick us with questions like that.

However, I am just in my first semester of nursing so what do I know...