Unit 2 and 3 Chapter 33 Aortic Abdominal Aneurysm and Thoracic Aneurysm Flashcards
What is an Aneursym
An aneurysm is a permanent localized dilation of an artery, which enlarges the artery to at least two times its normal diameter.
What is the most common life threatening complication of Aneurysms
. Rupture is the most frequent complication and is life threatening because abrupt and massive hemorrhagic shock results.
Are nonsymptomatic aneusryms usually discovered during imaging procedures?
Yes
Discovery on physical exam or
x-ray, when it reaches 5 cm
can be palpated, bruits can
be heard over aneurysms .
Which of the following is the most common tool to diagnose an ANEURSYM?
A.palpation
B.ausculation
C. computed tomography(CT)
D. Doppler
C. computed tomography(CT)
What is Abdominal Aortic Aneursyms
Abdominal aortic aneurysms (AAAs) account for most aneurysms, are commonly asymptomatic, and frequently rupture. Most of these are located between the renal arteries and the aortic bifurcation (dividing area).
Risk factors for Aneurysms, what is the most common cause
Atherosclerosis is the most common cause of aneurysms,
-hypertension,
-hyperlipidemia, and
-cigarette smoking being contributing factors.
NOMODIFIABLE
Age, gender, and family history also play a role
S/s of Abdominal Aortic Aneurysm
Assess patients with a known or suspected abdominal aortic aneurysm (AAA) for abdominal, flank, or back pain. Pain is usually described as steady with a
gnawing quality, unaffected by movement, and lasting for hours or days.
-A pulsation in the upper abdomen slightly to the left of the midline between the xiphoid process and the umbilicus may be present.
-. A detectable aneurysm is at least 5 cm in diameter.
- If expansion and impending rupture of an AAA are suspected, assess for
- WHEN RUPTURED
- severe pain of sudden onset in the back or lower abdomen, which may radiate to the groin, buttocks, or legs.
- Hematoma at the flank area
- hypotension
Nursing consideration for Abdominal Aortic Aneurysm
Auscultate for a bruit over the mass, but avoid palpating the mass because it may be tender, and there is risk for rupture!
Should you palpate the aneurysm?
No
What are pt’s at risk for when the aneursym ruptures
Patients with a rupturing AAA are critically ill and are at risk for hypovolemic shock caused by hemorrhage. Signs and symptoms include hypotension, diaphoresis, decreased level of consciousness, oliguria (scant urine output), loss of pulses distal to the rupture, and dysrhythmias. Retroperitoneal hemorrhage manifests with hematomas in the flanks (lower back). Rupture into the abdominal cavity causes abdominal distention.
What should the nurse do first for a patient with Aortic Abdoniaml Aneursym?
The size of the aneurysm and the presence of symptoms determine patient management. The nurse’s role is to perform frequent patient assessments, including blood pressure, pulse, and peripheral circulation checks.
Can hypertension worsen or decrease the size of an aneurysm?
A. decrease
B. worsen
B. worsen
patients with hypertension are treated with antihypertensive drugs to decrease the rate of enlargement and the risk for early rupture.
The desired outcome for a patient with an aneurysm?
-decrease size of aneurysm
-decrease hypertension
-PREVENT FROM RUPTURE
The desired outcome of nonsurgical management is to monitor the growth of the aneurysmand maintain the blood pressure at a normal level to decrease the risk for rupture.
What type of medications are used in the tx of Aneursyms
-antihypertensives
Is frequent vital signs amd imaging test necessary for a patient with a present Aneursym?
A. yes
B. no
A. yes
For those with small or asymptomatic aneurysms, frequent ultrasound or CT scans are necessary to monitor the growth of the aneurysm.
Emphasize the importance of following through with scheduled tests to monitor the growth.
Also explain the signs and symptoms of aneurysms that need to be promptly reported.
Which of the following signs and symptoms should be reported immediately for a patient diagnosed with Abdominal Aortic Aneursyn?
A. headache
B. Abdominal distention
C. hypertension
D. bruit over mass
B. Abdominal distention
sign of peritonitis and hemmorhage
What are the Clinical manifestations of a ruptured Abdominal Aortic Aneurysm
Patients with a rupturing AAA are critically ill and are at risk for
hypovolemic shock caused by hemorrhage.
**hypotension,
diaphoresis,
-decreased level of consciousness,
oliguria (scant urine output),
loss of pulses distal to the rupture, -dysrhythmias.
-Retroperitoneal hemorrhage manifests with hematomas in the flanks (lower back). -Rupture into the abdominal cavity causes abdominal distention.
Monitor:
√ Abdominal, back, groin, or peri-umbilical pain
(Gnawing pain lasting hours/days) √ Pulsating abdominal mass √ Diaphoresis √ Paleness √ Weakness √ Tachycardia √ Hypotension √ Changes in level of consciousness
-flank bruising
What is Thoracic Aortic Aneursym
Thoracic aortic aneurysms (TAAs) are not quite as common and are frequently misdiagnosed. They are typically discovered when advanced imaging is used to assess other conditions. TAAs commonly develop between the origin of the left subclavian artery and the diaphragm. They are located in the descending, ascending, and transverse sections of the aorta. They can also occur in the aortic arch and are very difficult to manage surgically.
Clinical manifestation of Thoracic Aortic Aneurysm
Signs include shortness of breath, hoarseness, and difficulty swallowing.
mass may be visible above the suprasternal notch.
Clinical Manifestations of Thoracic Aortic Aneurysm Rupture
Assess the patient with suspected rupture of a thoracic aneurysm for sudden and excruciating back or chest pain. Hypovolemic shock also occurs with TAA.
Which of the following is the standard tool of assessing the size and location of aneurysms
A.xray
B. CT
C.Doppler
D. Echocardiogram
B. CT
Computed tomography (CT) scanning with contrast is the standard tool for assessing the size and location of an abdominal or thoracic aneurysm.
Ultrasonography is also used.
Patient teaching /signs of rupture for AAA OR TAA
Teach patients receiving treatment for hypertension about the importance of continuing to take prescribed drugs. Instruct them about the signs and symptoms that must be reported promptly to the primary health care provider, which include:
* Abdominal fullness or pain or back pain
* Chest or back pain
* Shortness of breath’
* Difficulty swallowing or hoarseness
Surgical management of an aneurysm
For patients with a rupturing abdominal aortic or a thoracic aneurysm, emergency surgery is performed.
Patients with smaller aneurysms that are producing symptoms are advised to have elective surgery.
Those with smaller aneurysms that are not causing symptoms are treated nonsurgically until symptoms occur or the aneurysm enlarges.
