Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client?
A. HPN
B. Aneurysm rupture
C. Cardiac arrhythmias
D. Diminished pedal pulses
Correct Answer: B. Aneurysm rupture
Rupture of an aneurysm is a life-threatening emergency and is of the greatest concern for the nurse caring for this type of client. The layers of the aortic wall can also separate (aortic dissection). This produces severe, tearing pain in the chest, back or abdomen. The potential for rupture is the most serious risk associated with an aortic aneurysm. A ruptured aortic aneurysm can cause life-threatening internal bleeding and/or a stroke.
Option A: Hypertension should be avoided and controlled because it can cause the weakened vessel to rupture. Hypertension has been considered a potential risk factor for AAA; but the findings from prospective cohort studies have not been entirely consistent, nor have they been summarised in a comprehensive meta-analysis.
Option D: Diminished pedal pulses, a sign of poor circulation to the lower extremities, are associated with an aneurysm but aren’t life-threatening. The appearance of microembolic lower limb infarcts in a patient with easily palpable pedal pulses may suggest the presence of either popliteal or abdominal aneurysms.
Option C: Cardiac arrhythmias aren’t directly linked to an aneurysm. Ventricular aneurysms may cause shortness of breath, chest pain, or an irregular heartbeat (arrhythmia).