Aneursym

Manifestations of Aortic Aneursym

Flank abdominal pain abdominal bruit palpitable abdominal mass tender abdomen

Typical AAA patient

Mildly obese Sedentary male > 60, gerontological issues Smoker HTN, vascular disease, carotid artery disease, possibly diabetes

Dissecting Aneurysm

Most Lethal Outcome when blood leaks into layers of the arterial wall commonly occurs in the ascending aorta

Assessing aneurysms (PTA)

Palpable abdominal mass (PULSATILE ABDOMINAL MASS IN THE UPPER MIDDLE ABDOMEN) Tender abdomen - lower abdominal pain left of midline Abdominal Bruit

Issues with patient management (dissecting aneurysm)

Rapid Diagnosis, Surgery, Fluid Rehydration, Pain Management, managing existing diseases

Risk factors for Aneurysm

SHAME Smoking Hypertension Arthrosclerosis, Age, Auto immune disorders M E

Clinical Presentation of Dissecting Aneursym

Sudden, Unbearable chest pain, may feel like a rip or a tear in the body can present like a M.I - radiating pain associated with syncope - hypovolemic shock

Indication for Surgery for aneursym

Thoracic aneurysm: 5 - 6 cm Abdominal Aneurysm: 5cm or greater Aneurysm is growing rapidly patient is symptomatic with aneurysm

In aneurysm you can hear

turbulent blood flow through stenotic or dilated vessel.

Abdominal Aortic Aneurysm (4) patient is? location effect of hypertension

75% of aortic aneurysms occurs here patient is usually asymptomatic location: occurs b/w renal arteries and aortic bifurcation a lot of blood flowing - hypertension aids aneurysm development

Dissecting Aorta

A tear develops in the intima or the media degenerates resulting in a dissection. Commonly associated with hypertension, blunt chest trauma, and cocaine use.

Nursing interventions (Dissecting Aneurysm)

Assess for: back pain, falling (BP, hematocit) perineal hematomas, s/s of HF and abdominal bruit Control BP Manage Pain Stablize C.O Surgery , if possible survival depends on location of dissection, severity of complications, how rapidly diagnosed

Treating Stable Aneursym (3)

Control BP SPS (120-100) Hypertensive Meds (ABCD) Weight Control, constant monitoring Surgery

Complications of Aneurysm

Death Dissection or Rupture cardiac tamponade - Emboli Graft Occlusion (closed 100%)

Types of Surgery for Aneursym

Endovascular graft - giant stent (white upside down Y) Excision of Aneurysm resection of aorta - cut off parts of diseased aorta

patient presentation

Heart - Murmur, Myocardial Ischemia, CHF, Aortic Regurgitation, Irregular pulse, Pulse Pressure change brain - neurological changes, anxious body - N/V/Sweating

saccular aneurysm

a sac-like bulge on one side

dilation (ballooning) (outpouching) of an artery formed at a weak area in the vessel wall thrombi warning

aneurysm] site where thrombus can form

Nursing interventions for Aneurysm

assess functional capacity of all body systems maintain stable physiologic function assess for: (Emergency) Back pain, Low BP, Low HCT, Perineal Hematomas, s/s HF, Bruit

abdominal assessment (Aneursym)

be very careful with palpating the abdomen - can cause rupture

Fusiform Aneurysm

dilation of the entire circumference of the artery

Types of aneurysms

fusiform, saccular, dissecting

Pseudoaneurysm

pulsatile hematoma that results from leakage of blood into soft tissues abutting the punctured artery with fibrous encapsulation and failure of the vessel wall to heal