A 68-year-old male with a 15-year history

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 aneurysm. 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 98.9â—¦ F (37.2â—¦ 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. 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 until he is pain free. Monitor BUN and creatinine. Limit parenteral and oral fluid intake. SCIENCE HEALTH SCIENCE NURSING NSG 435

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