Which of these interventions should be the highest priority when caring for a patient with suspected abdominal aortic aneurysm (AAA) rupture?
Obtaining a STAT electrocardiogram
Inserting an indwelling urinary catheter
Increasing cardiac contractility
Maintaining blood pressure
The Correct Answer is D
A. Obtaining a STAT electrocardiogram: While obtaining an electrocardiogram (ECG) can be important in evaluating a patient's cardiac status, it is not the highest priority in the context of suspected AAA rupture. Immediate management focuses on stabilizing the patient and addressing potential hemorrhagic shock.
B. Inserting an indwelling urinary catheter: Inserting a urinary catheter may be necessary for monitoring urine output, but it is not the immediate priority when managing a suspected AAA rupture. The focus should be on life-threatening conditions first.
C. Increasing cardiac contractility: Increasing cardiac contractility may be relevant in some clinical situations, but it does not directly address the urgent need to maintain hemodynamic stability and prevent shock in a patient with suspected AAA rupture.
D. Maintaining blood pressure: Maintaining blood pressure is the highest priority intervention in this scenario. Patients with a suspected AAA rupture are at high risk for hypovolemic shock due to internal bleeding. Ensuring adequate blood pressure is critical to perfusing vital organs and stabilizing the patient before surgical intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. A woman presenting with malaise, lethargy, and copious nasal secretions: These symptoms are more indicative of a common cold or viral upper respiratory infection. While nasal secretions can occur in rhinosinusitis, the absence of facial pain or pressure suggests a cold rather than sinus involvement.
B. A man with a dry, stuffy nasopharynx, a sore throat, and temperature of 98.9°F: This presentation is typical of a common cold or upper respiratory infection. The symptoms of a dry, stuffy nasopharynx and sore throat are not specifically indicative of rhinosinusitis, which usually involves more pronounced nasal and facial symptoms.
C. A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9°F: This combination of symptoms strongly suggests rhinosinusitis. The presence of facial pain, headache, and fever indicates inflammation and infection of the sinuses, which is characteristic of rhinosinusitis rather than a common cold.
D. A woman complaining of generalized aches and who has a hoarse voice and reddened, painful upper airways: These symptoms align more closely with a viral upper respiratory infection or laryngitis. The absence of specific sinus-related symptoms such as facial pain or nasal obstruction makes rhinosinusitis less likely in this case.
Correct Answer is D
Explanation
A. Inflammation: Inflammation refers to the body's immune response to injury or infection and does not specifically denote a temporary deprivation of blood supply to a cell. It is characterized by redness, swelling, heat, and pain in the affected area.
B. Necrosis: Necrosis is the process of cell death that occurs when cells are irreversibly damaged, often due to a lack of blood supply or other injury. It is a consequence of prolonged ischemia rather than the temporary condition itself.
C. Infarction: Infarction refers to the death of tissue due to prolonged ischemia, resulting from an irreversible loss of blood supply. It indicates permanent damage and is not synonymous with a temporary deprivation of blood supply.
D. Ischemia: Ischemia is the term used to describe a temporary reduction in blood flow to a tissue or organ, resulting in a deficiency of oxygen and nutrients. This condition can lead to symptoms and may cause damage if prolonged, making it the correct answer for this scenario.
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