AAA

Question 1

Most common cause of Abdominal aortic aneurysm

Answer 1

Most common cause is atherosclerosis

Question 2

Common location of Abdominal aortic aneurysm

Answer 2

Most occur below the renal arteries

Question 3

Most prevalent ages for Abdominal aortic aneurysm

Answer 3

60-90 yr. of age

Question 4

Risk factors for AAA

Answer 4

Advanced age
Male sex
Obesity
smoking
ASCVD – Hypertension, high cholesterol (more than 50% of patients have hypertension)
Heart failure
Sleep apnea
Inflammatory conditions

Question 5

Abdominal aortic aneurysm

Answer 5

Damaged media layer of vessel, caused by weakness, trauma, or disease
Tends to enlarge

Question 6

Symptoms of AAA

Answer 6

Only about 40% of pts have symptoms
May feel heart beating in abdomen when lying down or feel a mass and throbbing
If AAA associated with thrombus- may have emboli; may cause cyanosis and have mottling of toes

Question 7

Classification of AAA

Answer 7

Aorta is normally 2-3 cm in diameter
When aorta increases to 1.5 times the normal width it is considered an aneurysm

Question 8

Assessment signs of AAA

Answer 8

Pulsating mass in middle & upper abdomen
80% of aaa can be palpated
May hear systolic bruit over mass

Question 9

Diagnostics for AAA

Answer 9

Ultrasound, CT to determine size, length, location
Q 6 month ultrasound if small ; some remain stable over years

Question 10

When should a AAA be repaired?

Answer 10

Not repaired until it is at least 5.5 cm wide

Question 11

Ruptured Aneurysm

Answer 11

Medical emergency – significant hemorrhaging
Hypovolemic shock can occur due to decreased venous return, decreased preload, decreased stroke volume and decreased cardiac output

Question 12

Red flag signs for Ruptured Aneurysm

Answer 12

back pain, hypotension, and tachycardia, pale clammy skin, altered LOC, back or flank ecchymosis (Grey Turners sign)

Question 13

NURSING MANAGEMENT OF AAA

Answer 13

Monitoring BP- IMPLEMENT MEDICAL THERAPIES TO STABILIZE FUNCTION
Functional capacity of all organ systems should be assessed
Signs of heart failure or loud bruit may suggest a rupture into the vena cava
Monitor for Signs of impending rupture:
severe back or abdominal pain, persistent or intermittent
Rupturing signs: constant intense back pain, falling BP, deceasing hematocrit
Rupture into peritoneal cavity is rapidly fatal
Retroperitoneal rupture- hematomas in scrotum, perineum, flank, penis

Question 14

Post-op management

Answer 14

Monitor pulmonary, cardiovascular, renal and neurologic status; AORTIC CLAMP PUTS PATIENTS AT RISK FOR
thrombus, nerve damage to legs, Hypoperfusion to kidney,

Question 15

Complications of AAA

Answer 15

BLEEDING, HEMATOMA, WOUND INFECTION
DISTAL ISCHEMiA OR EMBOLIZATION
DISSECTION, PERFORATION OF AORTA
GRAFT THROMBOSIS, INFECTION
GRAFT MIGRATION, LEAKS
DELAYED RUPTURE
BOWEL ISCHEMIA

Question 16

Nursing Management Aortic Dissection Preoperatively

Answer 16

Keep the patient in bed in a semi-Fowler’s position and maintain a quiet environment, to help keep the systolic blood pressure (BP) at the lowest possible level that maintains vital organ perfusion (typically between 110 and 120 mm Hg).
Medications are administered as prescribed.

Question 17

Nursing Management Aortic Dissection Postoperatively

Answer 17

Patient and caregiver teaching
Follow-up with regularly scheduled magnetic resonance imaging (MRI) or computed tomography (CT)
All patients with a history of aortic dissection, regardless of anatomical location or treatment modality, require long-term medical therapy to control BP.