The office nurse receives 4 telephone messages. Which client should the nurse call back first?

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11ecbb05_cbda_b02f_b433_a12ae5953c85_MD0009_00 An abdominal aortic aneurysm (AAA) is a blood-filled bulge in the abdominal aorta caused by weakening in the vessel wall due to increased pressure. Risk factors include male sex, age >65, coronary artery and peripheral vascular diseases, hypertension, and family and smoking history. AAA dissection (blood leakage into a vessel tear) or rupture may manifest as acute-onset abdominal pain radiating to the back and is typically associated with symptoms of hemorrhagic shock (eg, decreased systolic pressure; increased, weak pulses; pallor). This client's symptoms could indicate impending rupture, which can lead to life-threatening vascular hemorrhage. (Option A) This client's pain is most likely musculoskeletal in origin and due to a lumbosacral strain. Although assessment and treatment (eg, nonsteroidal anti-inflammatory drugs, muscle relaxants) are necessary, this is not a life-threatening condition. (Option B) This client's pain is most likely radicular (irritation of the sciatic nerve) in origin. Although neurovascular evaluation for a herniated disk (L5-S1) is necessary, this is not a life-threatening condition. (Option C) This client's pain and fever can be associated with a postoperative infection in the bone and surrounding tissue (osteomyelitis). Although diagnosis and treatment with prescribed antibiotics are crucial to prevent sepsis, a potential massive hemorrhage is a higher priority. Educational objective: Clients with atherosclerotic vascular disease in one system (eg, stroke, peripheral vascular disease) are more likely to have undiagnosed, underlying atherosclerotic vascular disease in other areas (eg, coronary disease, aortic aneurysm). Evaluation and treatment of a suspected abdominal aortic aneurysm dissection or rupture are critical as a vascular bleed is potentially life-threatening.

The Office Nurse Receives 4 Telephone Messages