aneurysm

Question 1

fusiform

Answer 1

circumferential and uniform in shape, outpouching on both sides

Question 2

Saccular

Answer 2

pouch-like with narrow neck

on one side

Question 3

true aneurym

Answer 3

all vessel layers intact

Question 4

What is a False/Pseudoaneurysm and what is a possible cause

Answer 4

Disruption in vessel wall layers
• Bleeding contained by surrounding
soft tissue; hematoma forms
• Trauma, arterial puncture,
artery/graft site

Question 5

Causes for aneurysm

Answer 5

Degenerative
– Congenital
– Mechanical
– Infectious
• Greater than 60yrs marked
increased in incidence

Question 6

Risk factors aneurysm

Answer 6

Risk Factors
– Male
– Age
– HTN
– CAD
– PAD
– Carotid disease
– Tobacco***

Question 7

What are the clinical manifestations of aneurysm

Symptoms/
Body clues

Answer 7

Often asymptomatic until dissection
– Incidental finding on X-ray or CT
– Symptoms include: back pain, epigastric discomfort, altered bowel habits, “blue
toe syndrome“ due to altered flow in the vessels
– Pulsatile mass is periumbilical area
– Bruit heard over site

Question 8

Diagnostics tests for aneurysms

Answer 8

Chest & Abdominal X-ray
• Echocardiography
• ECG (r/o MI)**
• Abdominal ultrasound
• **CT scan (with or without contrast) Gold STANDARD 
• MRI

Question 9

Treatment of aneurysms

Answer 9

Decrease growth rate
• Antibiotics
– Inhibit infections that are implicated in growth
• Statins
– Reduce progression of atherosclerosis

– Prevent complications
• Control HR and BP
– B-blocker (esmolol)
– Calcium Channel Blocker (diltiazem)
– Morphine (decrease SNS and pain) (not for asymptomatic aneurysms)

– Risk factor modification

Question 10

Surgical aneurysms

Answer 10

• Resection and repair with graft

Question 11

Endovascular repair aneurysms

Answer 11

• Placement of stent graft via
catheter
• Aneurysm shrinks down onto graft

better for older pts with complications

Question 12

Nursing Assessments aftr aneurysm repair

Answer 12

VS
• Neuro- at risk for stroke
• Pain
• Peripheral perfusion /sensation- good perfusion through graft site

• Abdominal auscultation and palpation

Question 13

As the nurse, what meds/instructions do you give to aneurysm recovery

Answer 13

• Administer medications
– Antihypertensives
– Statins
– Antibiotics
– Stool softeners: prevent strain 
• Activity restrictions – not crossing legs, bedrest around a day

Question 14

Complication Dissection

Answer 14

Disruption of intimal layer

• False lumen between intimal and
media vessel layers

• Blood diverted to false lumen

Question 15

Clinical symptoms of dissection

Answer 15

Sudden onset of severe and persistent pain
described as “tearing “or “ripping” in the anterior
chest or back and extending to the shoulders,
epigastric area, or abdomen.

(Pain can depend on where tear is)

• Diaphoresis, nausea, vomiting, faintness, and
tachycardia. (sounds like MI)

• Blood pressure is often markedly different from one
extremity to another and often decreases because of
loss of blood.

Question 16

Complications of dissection

Answer 16

RUPTURE!!!
• 90% fatal
• Acute massive blood loss
– Symptoms similar to dissection then
• Acute hypovolemic shock
• Unconsciousness
• Death