Keeping in mind insurance guidelines, at what point during primary-prevention screening and assessment should abdominal ultrasound be ordered, particularly in individuals who smoke, are older than age 50 years, and are at an increased risk of asymptomatic abdominal aortic aneurysm? At what interval should follow-up ultrasound be ordered? — Kevin Majchszak, CNP, Toledo, Ohio
The United States Preventive Services Task Force (USPSTF) recommends one-time screening for abdominal aortic aneurysm (AAA) by ultrasonography in men aged 65 to 75 years who have ever smoked. This recommendation is based on the major risk factors for AAA, which includes age, male sex, and a history of smoking 100 cigarettes in a person’s lifetime.
The USPSTF recommends against screening asymptomatic women and is uncertain about screening nonsmoking men. The Agency for Healthcare Research and Quality has a great free app for your smartphone or handheld device that provides an evidence-based resource for preventive care right at your fingertips. — Rebecca H. Bryan, APRN, CNP, Lecturer, Family Health Nurse Practitioner Program, University of Pennsylvania School of Nursing, Philadelphia (150-3)