Question

A nurse in the ED is admitting a client who has possible dissecting AAA. Which of the following actions is the priority for the nurse to take?

A. Administer pain medications as prescribed.
B. Provide a warm environment.
C. Administer IV fluids as prescribed.
D. Initiate a 12 lead ECG.

Answer 1

The priority action for a nurse admitting a client with possible dissecting AAA is to initiate a 12-lead ECG to quickly assess and guide treatment for this urgent condition.

Step-by-step explanation:

A nurse in the Emergency Department (ED) admitting a client who has possible dissecting Abdominal Aortic Aneurysm (AAA) needs to prioritize interventions based on the severity and acuteness of the condition. While all listed actions are important aspects of care, the priority for a patient with a dissecting AAA is to initiate a 12 lead ECG.

This is because a 12-lead ECG can help in the rapid assessment of cardiac rhythm and function, detect complications, and guide urgent treatment. In the case of a dissecting AAA, time is critical to prevent rupture and further complications. After the ECG, further stabilization, such as administering IV fluids or pain medications, and providing a warm environment, would follow according to the patient's condition and doctor's orders.