Anerurysms Flashcards
What is the aorta?
- Largest artery
- Responsible for supplying oxygenated blood to essentially all vital organs
What is an aortic aneurysm?
- Outpouchings or dilations formed at weak point in wall of the aorta
- Occur in men more often than in women
- Incidence ↑ with age
- Lined with intralumen debris such as plaque and thrombi
What are the two shapes of aortic aneurysms?
- fusiform
- saccular
What is a fusiform aortic aneurysm?
Circumferential, relatively uniform in shape
What is an saccular aortic aneurysm?
Pouchlike with narrow neck connecting bulge to one side of arterial wall
What happens if you leave an aortic aneurysm untreated?
They may rupture causing fatal hemorrhage.
What is the pathophysiology of an aortic aneurysm?
- All aneurysms involve a damaged media layer of the vessel.
- After an aneurysm develops, it tends to enlarge.
What is the risk factors of an aortic aneurysm?
- Genetic predisposition
- Smoking (or other tobacco use)
- Hypertension (more than ½ pts).
- May form as a result of: Atherosclerosis, trauma, infection, hereditary, immunologic conditions
what is an abdominal aortic aneurysm? (AAA)
- Occurs due to atherosclerosis
- Occur in 18% of men and 5% of women over 60
- Most occur below renal arteries
More common in:Whites, Men, Elderly
What is a thoracic aorta aneurysm?
- Thoracic is area in 85% of cases
- More frequent in men 40-70 years
- Most common site for dissecting aneurysm
- 1/3 die from rupture
What is the symptoms of a thoracic aortic aneurysm?
- Pulse and blood pressure difference in upper extremities, cough, dyspnea, dysphagia
- Pain and pressure symptoms
- INTERMITTENT AND NEUROLOGIC PAIN due to IMPINGEMENT ON NERVES
- Dilated superficial veins of chest
- Abnormal pulsation apparent on chest wall
- Cyanosis - vein compression of chest vessels
What is the complications of an aortic aneurysm?
- Rupture—serious complication related to untreated aneurysm
- Bleeding may be tamponaded by surrounding structures, thus preventing exsanguination and death
- Severe pain
- May/may not have back/flank ecchymosis
- Rupture into thoracic or abdominal cavity: Massive hemorrhage, Most do not survive long enough to get to the hospital
What is the diagnostic test used for aortic aneurysm?
ECG, echocardiography, ultrasonography, CT scan, MRI, abdominal or Chest x-ray, arteriography
What is the medical management for an aortic aneurysm?
- Most cases – surgery
–> If ruptured, emergent surgical intervention required - Controlling blood pressure
- Pulsatile flow is reduced by medications that reduce cardiac contractility (eg. propanolol).
What is the nursing management for an aortic aneurysm?
- Nursing assessment is guided by anticipating rupture and by recognizing that the patient may have other vascular impairments due to atherosclerosis.
- Functional capacity of all organ systems assessment.
What are the signs of impending rupture for an aortic aneurysm?
severe back pain or abdominal pain, which may be persistent or intermittent. ** Low back pain** is a serious symptom that denotes lumbar nerves compression by an aneurysm.
What are you looking for in an nursing assessment of an aortic aneurysm?
Be alert for sudden onset of sharp, ripping, or tearing pain located in anterior chest, epigastric area, shoulders, or back indicates rupture/dissection (thoracic)
What are the elders considerations for aortic aneurysm?
- Most abdominal aneurysms occur in patients between the ages of 60 and 90 years old.
- Rupture is likely with coexisting hypertension and with aneurysms wider than 5 cm.
What is the management for an aortic aneurysm?
- Follow small aneurysms (4 cm or less) with CT or US every 6 months and aggressively control BP
- Prognosis is poor for untreated patients as aneurysm enlarges
What are the two most difficult to treat in aortic aneurysm?
- Thoracic aneurysms
- atrial-femoral circulatory bypass
What is the pre-op care for an aortic aneurysm?
- Brief explanation of disease process
- Planned surgical procedure
- Preop routines: Bowel prep, NPO, Shower
What is the post-op care for an aortic aneurysm?
ICU monitoring
- Arterial line
- Central venous pressure (CVP) or pulmonary artery (PA) catheter
- Mechanical ventilation
- Urinary catheter
Ambulatory and home care
- Encourage patient to express concerns
- Instruct patient to gradually increase activities
- No heavy lifting
- Educate on signs and symptoms of complications:Infection, Neurovascular changes
What is end-vascular grafting of an aortic aneurysm?
repair of aneurysm using a stent graft, which is deployed via femoral artery
What is an resection of an aneurysm?
via abdominal incision and placement of prosthetic graft
