Anerurysms Flashcards

1
Q

What is the aorta?

A
  • Largest artery
  • Responsible for supplying oxygenated blood to essentially all vital organs
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2
Q

What is an aortic aneurysm?

A
  • 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
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3
Q

What are the two shapes of aortic aneurysms?

A
  1. fusiform
  2. saccular
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4
Q

What is a fusiform aortic aneurysm?

A

Circumferential, relatively uniform in shape

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5
Q

What is an saccular aortic aneurysm?

A

Pouchlike with narrow neck connecting bulge to one side of arterial wall

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6
Q

What happens if you leave an aortic aneurysm untreated?

A

They may rupture causing fatal hemorrhage.

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7
Q

What is the pathophysiology of an aortic aneurysm?

A
  • All aneurysms involve a damaged media layer of the vessel.
  • After an aneurysm develops, it tends to enlarge.
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8
Q

What is the risk factors of an aortic aneurysm?

A
  • Genetic predisposition
  • Smoking (or other tobacco use)
  • Hypertension (more than ½ pts).
  • May form as a result of: Atherosclerosis, trauma, infection, hereditary, immunologic conditions
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9
Q

what is an abdominal aortic aneurysm? (AAA)

A
  • 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
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10
Q

What is a thoracic aorta aneurysm?

A
  • 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
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11
Q

What is the symptoms of a thoracic aortic aneurysm?

A
  • 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
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12
Q

What is the complications of an aortic aneurysm?

A
  1. Rupture—serious complication related to untreated aneurysm
  2. Bleeding may be tamponaded by surrounding structures, thus preventing exsanguination and death
  3. 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
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13
Q

What is the diagnostic test used for aortic aneurysm?

A

ECG, echocardiography, ultrasonography, CT scan, MRI, abdominal or Chest x-ray, arteriography

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14
Q

What is the medical management for an aortic aneurysm?

A
  • Most cases – surgery
    –> If ruptured, emergent surgical intervention required
  • Controlling blood pressure
  • Pulsatile flow is reduced by medications that reduce cardiac contractility (eg. propanolol).
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15
Q

What is the nursing management for an aortic aneurysm?

A
  • 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.
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16
Q

What are the signs of impending rupture for an aortic aneurysm?

A

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.

17
Q

What are you looking for in an nursing assessment of an aortic aneurysm?

A

Be alert for sudden onset of sharp, ripping, or tearing pain located in anterior chest, epigastric area, shoulders, or back indicates rupture/dissection (thoracic)

18
Q

What are the elders considerations for aortic aneurysm?

A
  • 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.
19
Q

What is the management for an aortic aneurysm?

A
  • 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
20
Q

What are the two most difficult to treat in aortic aneurysm?

A
  1. Thoracic aneurysms
  2. atrial-femoral circulatory bypass
21
Q

What is the pre-op care for an aortic aneurysm?

A
  • Brief explanation of disease process
  • Planned surgical procedure
  • Preop routines: Bowel prep, NPO, Shower
22
Q

What is the post-op care for an aortic aneurysm?

A

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

23
Q

What is end-vascular grafting of an aortic aneurysm?

A

repair of aneurysm using a stent graft, which is deployed via femoral artery

24
Q

What is an resection of an aneurysm?

A

via abdominal incision and placement of prosthetic graft