AAA

Question 1

What item is important to check regarding age of blood cells before starting a transfusion?

Answer 1

Expiration date (notifies nurse regarding age of RBCs)

Question 2

Rationale for administering beta blocker for stable AAA?

Answer 2

To reduce BP and decrease stress on the aortic wall

Question 3

After stopping the transfusion because of a transfusion reaction, what should you do next?

Answer 3

Prime a new line and run NS at a keep vein open rate

Question 4

Risk factors for atherosclerosis?

Answer 4

Hx of smoking, elevated LDL/decreased HDL, HTN

Question 5

What is an aortic dissection?

Answer 5

Tear in the tunica intima that causes acute onset of severe pain. Affects men>women. Occurs more common during 60-65. Aorta can rupture because of the tear and cause occlusion of arterial supply to vital organs=hemorrhage

Question 6

What is an aneurysm?

Answer 6

Ballooning of an artery causes permanent dilation of the aorta wall. Larger aneurysm=greater rupture risk.

Question 7

Different types of aneurysms?

Answer 7

1. Fusiform- dilation to entire circumference of artery
2. Saccular- out punching (sac) created affecting a portion of the artery
3. True aneurysm- arterial wall weakened by congenital/acquired problems
4. False aneurysm- result of vessel injury/trauma to 3 layers of arterial wall
5. Dissecting aneurysm- formed when blood accumulates in artery wall and ligaments are torn

Question 8

Risk factors for aneurysms?

Answer 8

HTN, smoking, male, male over 65+, older age, genetics (fam hx of AAA), atherosclerosis

Question 9

What causes aneurysms?

Answer 9

Arteriolosclerosis caused by calcification, HTN, and atherosclerosis

Question 10

Abdominal vs thoracic aneurysm symptoms and what are they?

Answer 10

AAA- 75%, more common, frequently rupture, S+S: abdominal/flank/back pain that’s unaffected by movement, lasts for hrs/days, pulsation in upper abdomen, excessive sweating, N/V, faint, pallor/gray, rapid/weak pulse, BP increased

TAA- 25%, can have symptoms of cough/cold/back pain/SOB because of compression on structures, often misdiagnosed, discovered when imaging is used to assess other conditions

Question 11

What does a ruptured AAA cause?

Answer 11

Severe pain/ripping sensation that may radiate, hypo tension, dizzy, and shock. Ruptured required emergent surgical intervention. Intact AAA are often asymptomatic.

Question 12

Dx for AAA?

Answer 12

CT with contrast is the standard, also MRI, ultrasound, ECG to rule out MI, chest/abdomen x-ray

Question 13

Surgical management of AAA?

Answer 13

Recommended once it’s grown >5 cm in 6 months. 2 types are open surgical repair (insert arterial graft into aorta, mortality rate high) and EVAR (endovascular repair- less invasive, not option for urgent cases, graft threaded through catheter and stent graft released and opens up above aneurysm).

Question 14

Medical management of AAA?

Answer 14

Smoking cessation, montior BP, blood administration, educate on good lifestyle

Question 15

Nursing management for AAA?

Answer 15

Monitor BP, IV fluid/blood components (monitor UO), monitor peripheral perfusion (CMS checks), pt education (lifestyle, smoking, BP control), and monitor blood administration to manage AAA