Nursing Actions for Post-Abdominal Aortic Aneurysm Repair Care: Indicated, Contraindicated, or Nonessential

QUESTION

A 68-year-old male with a 15-year history of hypertension and elevated cholesterol who is a two pack per day smoker had an open aneurysm repair (OAR) for a 6 cm abdominal aortic aneurism. The surgery was performed 2 days ago, and he was transported to a surgical unit after 1 day in the intensive care unit. He is awake and alert and has a large abdominal dressing that is clean and dry. The patient is NPO and has a nasogastric tube that is connected to low intermittent suction draining a small amount of brown-colored secretions. Vital signs: Temperature 98.9◦ F (37.2◦ C), pulse 92 bpm, respirations 16, blood pressure = 138/80 mmHg. He is drowsy but oriented and verbalizes 4/10 incisional pain using the pain intensity scale. He is using his PCA for pain control. NGN Item Type: Matrix Use an X for the nursing actions listed below that are Indicated (appropriate or necessary), Contraindicated (could be harmful), or Nonessential (makes no difference or not necessary) for the patient’s care at this time. Only one selection can be made for each nursing action. Nursing Action Indicated Contraindicated Nonessential Provide frequent oral care. Assess the carotid pulse. Maintain patient on bedrest

ANSWER

Nursing Actions for Post-Abdominal Aortic Aneurysm Repair Care: Indicated, Contraindicated, or Nonessential

Introduction

In the care of a 68-year-old male who underwent an open aneurysm repair (OAR) for an abdominal aortic aneurysm, it is crucial to ensure appropriate nursing interventions. In this essay, we will assess the nursing actions provided and determine whether they are indicated, contraindicated, or nonessential for the patient’s current postoperative condition.

Indicated Nursing Actions

Provide frequent oral care: Indicated. Frequent oral care is essential for maintaining the patient’s oral hygiene and comfort. It prevents dryness and discomfort, especially since the patient is NPO (nothing by mouth) and may experience oral dryness.

Assess the carotid pulse: Indicated. Assessing the carotid pulse is a crucial part of monitoring the patient’s cardiovascular status, especially after a major surgery like an abdominal aortic aneurysm repair. It helps ensure proper blood flow and cardiac function.

Maintain the patient on bedrest: Indicated. The patient had surgery two days ago and was recently transferred from the intensive care unit to a surgical unit. In the early postoperative phase, it is essential to maintain the patient on bedrest to prevent complications and ensure proper healing.

Contraindicated Nursing Actions

None of the listed nursing actions are contraindicated based on the patient’s current condition. However, it’s essential to keep monitoring the patient for any changes that may alter the appropriateness of these actions.

Nonessential Nursing Actions

Maintain the patient on bedrest: Nonessential. While bedrest is indicated in the early postoperative phase, it may become nonessential as the patient’s condition improves. The patient’s mobility and activity level should be gradually increased under medical guidance to prevent complications associated with prolonged immobility.

In summary, providing oral care, assessing the carotid pulse, and maintaining the patient on bedrest are indicated nursing actions for the postoperative care of a 68-year-old male following abdominal aortic aneurysm repair. It is essential to monitor the patient’s condition closely and adjust the care plan as necessary to ensure a safe and effective recovery.