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NSG 2202 > Aortic Aneurysm/Test 2 > Flashcards

Aortic Aneurysm/Test 2 Flashcards

1
Q

Definintion of Aortic Aneurysm

A

*Weakness within the arterial wall
*Localized ballooning of an artery
*Increases to about 50% of it’s size
Exact cause unknown

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2
Q

Risks for Aortic Aneurysm

A
  • HTN, HTN, HTN
  • Atherosclerosis
  • Congenital weakening of the wall
  • Weakening due to connective tissue diseases
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3
Q

Significance of Aortic Aneurysm

A
  • 2-3% of unselected population
  • M:F 5:1
  • Age >60 years
  • High risk of rupture if:
  • > 5 cm
  • expanding rapidly
  • saccular
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4
Q

Locations in the aorta

A
  • Thoracic- above diaphragm

* Abdominal- below diaphragm

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5
Q

Aortic Aneurysm Labels

A
  • Fusiform
  • Saccular
  • Dissecting
  • Ruptured
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6
Q

Fusiform

A

Entire circumference affected- football

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7
Q

Saccular

A

on side of the vessel (easiest to rupture-bike tire)

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8
Q

Dissecting

A

blood accumulates between layers of vessel r/t tears in intimal lining

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9
Q

Ruptured

A

Bursts

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10
Q

Symptoms of aortic aneurysm

A
  • Thoracic:
  • Tearing pain, tearing sensation within chest
  • HTN
  • Abdominal
  • pulsating mass in the abdomin
  • Pain- abdominal, flank, back, groin
  • HTN
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11
Q

Diagnostics of Aortic Aneurysm

A
  • Ultrasound
  • Cat Scan
  • Xray
  • Arteriogram/Aortagram
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12
Q

Nursing Diagnoses of Aortic Aneurysm

A
  • Ineffective Tissue Perfusion
  • Pain
  • Impaired gas exchange
  • PC: Rupture or hemorrhage
  • Many PC’s
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13
Q

Medical Management for Aortic Aneurysm

A
  • Control risks, trend size
  • Prevent increase in size
  • Surgical treatment if >5 cm
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14
Q

Treatment for Aortic Aneurysm

A
  • Anit-hypertensives
  • Keep stress under control
  • Surgery or resection of the aneurysm and creation of a new artery or graft.
  • Endovascular procedures
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15
Q

Endovascular procedures

A
  • New method for non-emergency treatment to repair
  • 2 small incisions in groin
  • catheter with balloon and graft inserted
  • inflated at aneurysm site
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16
Q

Traditional Graft Surgery

A
  • Recommended if >6 cm wide
  • May be elective if 4-6 cm
  • Midline abdominal incision
  • Aorta clamped above and below aneurysm-quick procedure*
  • Aneurysm opened
  • Dacron graft placed within
  • Aneurysm sac wrapped around the graft
  • pre op note pedal pulses
  • post op: assess bowel sounds
  • *Reglan med
17
Q

Pre Op Care

A
  • Prop respiratory and cardiac assessment
  • Perpheral pulses for baseline
  • BP must be under control
  • Measure abdominal girth
  • Type and cross
18
Q

Post Operative Patient

A
  • oxygenation
  • circulation
  • perfusion
  • wound
  • GI elimination
  • renal function
  • mobility
  • pain
19
Q

Post Op Nursing

A
  • Impaired gas exchange
  • respirations
  • O2 sat
  • breath sounds
  • depth
  • sputum
  • Free from atelectasis/pneumonia
  • position
  • pulmonary toilet
  • ISE
  • splinting
  • abdominal binder
  • out of bed
20
Q

Post op potential complications

A
  • Hemorrhage Nurse prevents
  • pulse -Measures
  • b/p -trends
  • skin -reports
  • metal status -plans ahead
  • UO -available IV sites
  • abdominal girth
  • CVP
21
Q

Post Op complications

A
  • Ineffective tissue perfusion r/t temporary decrease in blood supply in sx
  • pulses
  • skin
  • color
  • movement
  • sensation
  • pain
  • Maintain perfusion to periphery
  • extremity assmt
  • assess/mark pulses
  • heparin/lovenox SQ
  • TEDS/SCDs
  • positioning
  • ***NEVER CRIMP A GRAFT
22
Q

Post Operative Nursing

A
  • Altered tissue integrity
  • large abdominal incision
  • Free from dehiscence
  • assess
  • report redness, swelling, disruption, abd. distention
  • abdominal binder and splinting
  • DM- keep blood sugar controlled, increased chance of impaired wound healing
23
Q

Post Operative Complications

A
  • Ischemic Bowel
  • Abdominal distention
  • decreased or absent bowel sounds
  • Return of normal GI function
  • Assess
  • NG to intermittent suction
  • Ambulate
  • Reglan
  • Document return of BS or passing flatus
  • Stool softeners later
24
Q

Post Operative Complications

A
  • Renal failure
  • decreased urine output
  • swelling
  • increased BUN/Cr
  • Manage to prevent or detect early
  • I&O
  • wt qd
  • daily labs, BUN/Cr
  • Changes in HR, BP
25
Q

Post Op Nursing

A
  • Pain
  • anxious
  • uncooperative
  • grimace
  • rating at 10
  • Pain level at 3
  • medicate-morphine/dilaudid
  • turn and reposition
  • skin care
  • abd binder
  • pillow for splinting
26
Q

Post Op Nursing

A
  • decrease mobility
  • major surgery
  • weakness
  • pain
  • Return to ADL functioning
  • early ambulation
  • up to chair TID
  • progressive
  • bedside rehab
  • rehab
  • strenghthening
27
Q

Nurse Discharge

A
  • Teach
  • Home medications BP, BP, BP
  • No straining, no constipation, no lifting >10 lb
  • Progressive activities
  • Control risk factors
28
Q

Aortic Dissection

A
  • Usually acute, life threatening
  • Blood accumulates between the tear
  • More pressure at the site, less blood flow to organs
29
Q

Symptoms of aortic dissection

A
  • Severe pain, tearing or ripping
  • chest, intrascapular, abdomen to legs
  • Cardiovascular
  • Neurological
  • Respiratory
30
Q

Conservative Treatment if slow dissection

A
  • Bed rest
  • Pain relief
  • Prevent ischemia to organs
  • Control of b/p- Nipride (med)
  • Control cardiac contractility- Beta Blockers
  • Transfuse if blood loss
  • Prepare for surgery
31
Q

Emergency-Ruptured Abdominal Aortic Aneurysm

A
  • pulsating sensation in the abdomen
  • severe, sudden pain in abdomen
  • radiation to groin and back
  • abdominal rigidity
  • signs of hypovolemic shock
  • Pallor
  • anxiety
  • increased HR, decreased BP, decreased urine output
  • dry skin
  • excessive thirst
32
Q

Rupture

A
  • Immediate surgery
  • 50% mortality rate
  • results
  • more blood loss
  • more ischemic disease
33
Q

Treatment: ruture

A
  • Transfuse
  • blood
  • IV fluids
  • Support airway
  • Immediate surgery
34
Q

Post op care

A
  • More critical

* Greater chance of ischemic complications

NSG 2202 (22 decks)

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