Aneurysm&Dissection

Question 1

________= Dilation of artery due to weakening of the arterial wall

Answer 1

Aneurysms

Question 2

true vs false aneurysm

Answer 2

• True Aneurysm = Congenital or acquired
• False Aneurysm (pseudo)= Vessel trauma

Question 3

most common location for an aneurysm

Answer 3

abd aorta

Question 4

_________ increases chances of rupture (biggest contributor to acquiring an aneurysm)

Answer 4

HTN

Question 5

risk factors for developing aneurysm

Answer 5

• Smoking
• Hypertension
• Atherosclerosis **
• Age- >50, likely to rupture over 65
• Gender- men more likely
• Family History
• Marfan (inherited disorder that affects connective tissue)

Question 6

s/s of thoracic aneurysm + rupture

Answer 6

◦ Back pain
◦ SHOB
◦ Hoarseness
◦ Difficulty Swallowing

rupture:
• Sudden and severe back or chest pain
• Signs of shock

Question 7

s/s of AAA + rupture

Answer 7

◦ Abdominal, flank or back pain
◦ Pulsation in upper abdomen
◦ Bruit (Listen/ don’t palpate)

rupture:
• Sharp sudden pain in back/ lower abdomen
• Hypotension
• Diaphoresis
• Confusion/ LOC
• Loss of pulse distal to rupture
• Dysrhythmias
• Retroperitoneal hemorrhage = Flank bruise
• Abdominal Distension

Question 8

interventions for aneurysm

Answer 8

• Monitor growth
• Control hypertension
• Surgery
◦ Elective
◦ Emergency
◦ Resection/ Repair
‣ High mortality rate
• Endovascular stent graphs

Question 9

post op care for aneurysm surgery

Answer 9

• Home, SNF, Rehab
• Limited activity
• Incisional care
• No lifting 6-12 weeks
• No driving
• Assistance with ADL’s

Question 10

caused by a tear in inner layer or artery (Intima) of the aorta=

Answer 10

aortic dissection

Question 11

aortic dissection- chill or not chill

Answer 11

not chill! emergency

Question 12

dissection aorta assessment findings

Answer 12

• Pain
• Sharp tearing/ ripping/ stabbing
• 10/10 pain
• Moves through the chest, back, neck, throat, jaw or teeth
• Diaphoresis- shock
• Nausea & Vomiting
• Apprehension
• Hypertension until situation worsens –> Sudden hypotension
• Decreased pulses
• Aortic regurgitation
• Murmur
• Altered level of consciousness

Question 13

diagnotics for aortic dissection

Answer 13

• Chest X-ray
• CT scan
• Aortic Angiography
• Transesophageal Echocardiogram

Question 14

interventions for aortic dissection

Answer 14

• Two large bore IV’s
• Reduce blood pressure 100-120 SBP
◦ IV Beta Blocker
◦ IV Nicardipine
• Pain reduction (Morphine)
• Foley Catheter
• Surgery
◦ Cardiopulmonary bypass
◦ Synthetic graft

Question 15

dissection vs aneurysm

Answer 15

dissection = tear
aneurysm = bulge