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MS > ANEURYSM > Flashcards

ANEURYSM Flashcards

1
Q

❖ There is bulging or dilation of the arterial wall.

A

ANEURYSM

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2
Q

Aneurysms can lead to ____, especially if they
rupture, as the bleeding can cause damage to
the brain.

A

stroke

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3
Q

❖ CLASSIFICATION (by appearance)

A

Saccular

Fusiform

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3
Q

____ blood pressure increases the risk
of aneurysm rupture. Over time, aneurysms can cause _____ and further weakening of the vessel walls, increasing the risk of rupture.

When a brain aneurysm ruptures, it can result in a ______.

A

High

arterial dilation

cerebrovascular accident (CVA)

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4
Q

❖ CLASSIFICATION (by appearance)

The entire circumference of the vessel is involved

A

Fusiform

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4
Q

TYPE OF ANEURYSM
This is the most common type of aortic aneurysm. It occurs in the abdominal aorta, which is the main blood vessel that carries blood away from the heart to the lower part of the body.

A

Abdominal Aortic Aneurysm (AAA)

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4
Q

TYPE OF ANEURYSM

These are located in the blood vessels of the brain. They can be particularly dangerous if they rupture, leading to a subarachnoid hemorrhage.

A

Brain Aneurysm (Cerebral Aneurysm)

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5
Q

❖ CLASSIFICATION (by appearance)

A bulge on only a portion of the artery wall.

A

Saccular

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5
Q

3 TYPES OF ANEURYSM

A

Brain Aneurysm (Cerebral Aneurysm)
Thoracic Aortic Aneurysm
Abdominal Aortic Aneurysm (AAA)

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6
Q

TYPE OF ANEURYSM

This type of aneurysm occurs in the thoracic aorta. It can involve the ascending aorta, aortic arch, or descending aorta.

A

Thoracic Aortic Aneurysm

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6
Q

Thoracic Aortic Aneurysm

▪ Located above the ______.
▪ Account for about 25% of all aneurysms.

A

diaphragm

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7
Q

Abdominal Aortic Aneurysm (AAA)

▪ Located below the ________.
▪ Account for about 75% of all aneurysms.
▪ If it ruptures, it will accumulate in the _______, and you may die within 1 hour.
▪ Increased pressure in the abdomen secondary to a tap water enema could cause the AAA to rupture.

▪ If the patient is thin:
➢ _____ is present
➢ Assess at eye level and look for any ______ in the abdomen.
➢ If ______ is present, measure the ______.
* Place the tape measure at the highest point in cm or inches

A

renal arteries

abdominal cavity

Bulging

pulsation

pulsation - abdominal girth

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8
Q

Aortic aneurysms LESS than 5cm in diameter are treated

A

medically

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8
Q

is used to determine the size, length, and location of the aneurysm

A

Duplex Ultrasonography

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9
Q

Duplex Ultrasonography test is done every ______ months until aneurysm reaches the size where surgery is needed to prevent the rupture because patient may die due to

A

6

hypovolemic shock

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9
Q

Aortic aneurysms GREATER than 5cm in diameter are treated

A

surgically

9
Q

Exact cause is

A

unknown

10
Q

→ Typically present at birth.
→ No capillary
→ The artery is directly connected to the vein

A

❖ ARTERIO VENOUS MALFORMATION (AVM)

10
Q

PATHOPHYSIOLOGY

→ The aorta is composed of 3 layers of tissue:

A

▪ Intima (innermost)
▪ Media (middle)
▪ Adventitia (outermost)

10
Q

❖ ARTERIO VENOUS MALFORMATION (AVM)

→ The artery is directly connected to the vein
▪ This direct connection causes _____ arterial blood to flow directly into veins making the veins _____.
▪ As you grow older, the artery will dilate the vein due to ______
▪ It is a congenital defect.

A

high-pressure

dilate

increased pressure

10
Q

PATHOPHYSIOLOGY

Produces Nitric Oxide
innermost

A

Intima

11
Q

PATHOPHYSIOLOGY

Middle
- compose of muscle tissue, elastin, collagen

A

Media

12
Q

PATHOPHYSIOLOGY

outer

A

Adventitia

13
Q

_____ responsible for aorta to stretch and response to any pressure changes

A

elastin

14
Q

limits aorta to distend extensively; holds aorta together

LIMITS DISTENTION

A

collagen

15
Q

As you grow older, ____ changes occur.
Elastin and collagen decrease, leading to the thinning of the artery. This can cause the artery to _____ and lose its normal integrity, potentially resulting in an aneurysm

A

degenerative

dilate

16
Q

CLINICAL MANIFESTATIONS

→ Thoracic Aortic Aneurysm

▪ (C, D, AP) that may occur only at ____ position.
▪ _____ due to pressure of the aneurysm against the trachea or the lungs.
▪ Cough, frequently paroxysmal and with a brassy quality; hoarseness, stridor, or vocal weakness or aphonia resulting from pressure against the laryngeal nerve.
▪ _____ due to impingement on the esophagus by the aneurysm.

A

Constant, dull, and achy pain ; supine

Dyspnea

Dysphagia

16
Q

CLINICAL MANIFESTATIONS

→ Abdominal Aortic Aneurysm

▪ Patient can feel heart beating in their abdomen when ______.

▪ Signs of impending rupture include (SB/AP, LBP, DH)
➢ Low back pain because of pressure of the aneurysm on the lumbar nerves.

▪ Retroperitoneal rupture of an aneurysm may result in hematomas in the scrotum, perineum, flank, or penis.

▪ A ___ bruit indicates that the aneurysm may have ruptured into the vena cava.

A

lying down

severe back or abdominal pain, falling blood pressure, and decreasing hematocrit

loud

17
Q

❖ SURGICAL MANAGEMENT FOR ANEURYSM

A

→ Open Surgery
→ Endovascular Stent Grafting

18
Q

❖ SURGICAL MANAGEMENT FOR ANEURYSM

→ Open Surgery

A

A large incision is made in the body to directly access the aneurysm. The surgeon opens the affected blood vessel and uses a graft to replace the weakened or bulging section of the vessel. The graft is sewn in place, effectively bypassing the aneurysm.

18
Q

❖ SURGICAL MANAGEMENT FOR ANEURYSM

→ Endovascular Stent Grafting

A

It is a minimally invasive procedure. It involves inserting a stent-graft into the aneurysm through a catheter. The stent-graft is positioned to exclude the aneurysm from the bloodstream, reducing pressure on the weakened vessel wall

19
Q

❖ POSTOPERATIVE CARE

→ Risk for Hemorrhage

A

▪ Monitor for the following:
➢ Tachycardia
➢ Decrease in BP
➢ Clammy skin
➢ Restlessness
➢ Decrease in LOC
➢ Oliguria

20
Q

❖ POSTOPERATIVE CARE

→ Risk for Aneurysm Rupture

A

▪ Keep the patient’s BP within the normal range.
➢ An elevated BP stresses the graft site and also increases myocardial oxygen demand.

▪ IV Beta-Blockers and Nitroprusside as ordered.
➢ Nitroprusside is a vasodilator that decreases the afterload.
➢ Careful infusion of IV Fluids (LRS or 0.9% NaCl or Blood Products) help stabilize BP.

▪ Keep the head of the bed elevated to 45 degrees or less to prevent tension of the graft.

▪ Maintain bed rest with legs flat because elevating or crossing the legs restrict peripheral blood flow and increases pressure in the aorta.

▪ The backrest elevation of the patient should not exceed 30 degrees to 45 degrees since sharp hip flexion could cause the aortic graft to kink.

▪ Prevent straining during defecation and instruct to avoid holding the breath while moving.
➢ Let the patient ambulate and increase fluid intake.

▪ Provide calm environment by implementing measures to reduce psychologic stress.

21
Q

❖ POSTOPERATIVE CARE

→ Risk for Ineffective Tissue Perfusion

A

▪ Assess dorsalis pedis and posterior tibial pulses every hour for 24 hours.

▪ Assess for pins and needles sensation, and numbness every hour for 24 hours.

22
Q

❖ POSTOPERATIVE CARE

→ Risk for Infection

A

▪ Monitor temperature every 4 hours and any signs of post implantation (stent) syndrome.

▪ Post implantation syndrome begins within 24 hours of stent graft placement and consists of spontaneously occurring fever, leukocytosis, & transient thrombocytopenia.

23
Q

❖ POSTOPERATIVE CARE

→ Patient’s Teaching

A

▪ Increase fluid intake or continue IV infusion until the patient can drink to maintain blood flow through the arterial repair site and to assist the kidneys with excreting IV contrast agents and other medications used during the procedure.
▪ 6 hours post-op, patient may be able to roll side to side and may able to ambulate with assistance.
——————–
▪ For leg swelling, the leg should be wrapped in elastic bandages or support stockings.
▪ No heavy lifting of heavy objects for 6 to 12 weeks postoperatively.
▪ Avoid smoking, foods high in fats, and sodium.
▪ Eat foods high in fiber such as oats, apples, pears, almonds, chia seeds, and avocadoto lower cholesterol level.
▪ Exercise in moderation.
▪ Take Antihypertensive drugs as prescribed

MS (34 decks)

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