cardio vascular stressors

Question 1

two types of aneurysms

Answer 1

abdominal (AAA)

thoracic (TAA)

Question 2

3layers of aorta

Answer 2

1. intima-endothelial connective tissue (inner)
   sub-endothelial connective tissue
2. tunica media- smooth muscle cells
3. adventitia- connective tissue(outer)

Question 3

normal aorta size

Answer 3

3cm at origin; 2.5cm descending thoracic; 1.8cm abdominal

Question 4

aneurysms

Answer 4

1. means permanent, pathologic dilatation of a segment of a vessel
2. caused by injury, disease, or conginetal weakness
3. aorta is prone to high pressures and shear stress
4. occurs usually bet the renal arterier and aortic bifurcation (where aorta spreads off to the kidney)

Question 5

who’s at risk for aneurysm

Answer 5

men, age 40, family hx, congenital defect at birth, pregnancy, smoker, COPD, hyperlipidemia, poorly controlled diabetes, htn, connective tissue disorders, infx:Syphillis and TB.

Question 6

types of abdominal aneurysm

Answer 6

true:

1. involves 3 layers
2. describe by shape
   a. saccular-one sided
   b. fusiform-two sides

Question 7

types of abdominal aneurysm

Answer 7

false (Pseudoaneurysm)

1. does not involve all 3 layers
2. caused by a trauma
3. perivascular clot may be present

Question 8

sx of thoracic aneurysm

Answer 8

asymptomatic
pain in the jaw, neck, and upper back
chest or back pain
coughing, hoarseness, or difficulty breathing
dysphagia

Question 9

sx of abdominal aneurysm

Answer 9

often asymptomatic
chest,lower, back, or scrotum pain,
strong pulsation, sensation of abd, palpable nontender upper abdominal mass,cystolic bruit

Question 10

treatment options

Answer 10

1. first priorities-aortic dissection-hemodynamic
2. limit dissection by lowering systemic arterial pressure and reduce cardiac contractility
   a. beta blocker
   b. nitroprusside-nitrate= lowers bp
   * DO NOT give hydralazine contraindicated-direct vasodilation can worsen the dissection

Question 11

surgical tx of aneurysm

Answer 11

1. open repair
2. emergency or scheduled
3. percutaneous -endovascular stent grafting

Question 12

Post op assessment

Answer 12

neurologic status
cardiac rhythm and vital signs
hemodynamic
urine output >30/hr
pain
surgical sites
neurovascular checks for lower extremities

Question 13

post op nursing care

Answer 13

monitor for complications

• endoleaks
• trauma to arteries
• occlusion of the renal or hypogastric arteries
• infx
• renal impairment

Question 14

post op goals

Answer 14

prevent htn SBP<120
cardiac support fx
nitroprusside with esmolol or labetalol
monitor for renal fx and ischemic colitis

Question 15

arteriosclerosis

Answer 15

arteriosclerosis refers to any stiffening or hardening of arteries often asso with HTN

Question 16

atherosclerosis

Answer 16

hardening of an artery specifically due to PLAQUE; most common form of arteriosclerosis

Question 17

effects of atherosclerosis

Answer 17

1. occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called PLAQUES
2. plaques can make the artery narrow and less flexible, restricting blood flow
3. pieces of plaque can break off and move thru the affected artery to smaller bld vessels, blocking them and causing tissue damage or death (embolization)
4. Bld clots can also form around a tear or fissure in the plaque leading to blocked blood flow (complicated lesions)

Question 18

risk factors for atheros

Answer 18

diabetes
High bld pressure
heavy alcohol use
hi fat diet
increasing age
obesity
personal or family history of heart disease
smoking

Question 19

symptoms atheros

Answer 19

usually do not occur until blood flow becomes restricted or blocked
can affect many different organ systems, including the heart, lungs, brain, intestines, kidneys, and limbs (extremities)

Question 20

Atheros tx

Answer 20

include life style changes, meds, and medical procedures or surgery.

Question 21

goal of tx

Answer 21

relieving sx,
reducing risk factors
lowering the risk of bld clots forming
widening or bypassing plaque-clogged arteries
preventing Atheros-related disease