Aneurysms Flashcards

(50 cards)

1
Q

What is an aneurysm?

A

ANEURYSM = outpouching or dilation of a vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What happens when an aneurysm ruptures?

A

When an aneurysm ruptures, the vessel ruptures or breaks, allowing the blood to flow outward = NOT GOOD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Is an aneurysm very common?

A

No; however, it is the most common issue/problem to occur in the aorta!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who is at highest risk?

A

Men more than women, and the highest risk ethnicity is whites; elderly = higher risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

is it better to have a smaller or larger aneurysm?

A

smaller; the larger the aneurysm = the higher risk for rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what can cause/lead to an aneurysm? - DEGENERATIVE

A

smooth muscles start to degenerate; allowing for/increases chance of outpouching/dilation of vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what can cause/lead to an aneurysm? -ATHEROSCLEROSIS

A

weakening of the aortic wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what can cause/lead to an aneurysm? - MECHANICAL

A

mechanical issues = blunt trauma/penetration to aorta; cardiac catheterization can even lead to one; the cath can penetrate the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what can cause/lead to an aneurysm? - INFLAMMATORY RESPONSE

A

infections can lead to inflammation; inflammation of the aorta and can lead to an aneurysm!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are some risk factors that can lead to an aneurysm? - MODIFIABLE

A
  • smoking
  • HTN
  • CAD
  • high cholesterol
  • obesity
  • PAD of lower extremities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are some risk factors that can lead to an aneurysm? - SMOKING; what can we do?

A

Encourage smoke cessation; offer education on how to stop smoking; advocate for Rx for quitting smoking, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are some risk factors that can lead to an aneurysm? - HTN; what can we do?

A

ensure patient is taking their medications to lower their B/P; advocate for Rx prescribed for HTN if patient doesn’t already have one, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are some risk factors that can lead to an aneurysm? - CAD; what can we do?

A

help patient lower risk of/reduce issue of CAD; medications, exercise, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are some risk factors that can lead to an aneurysm? - HIGH CHOLESTEROL

A

ensure cholesterol lowering medications are being taken by patient; encourage good exercise and diet!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are some risk factors that can lead to an aneurysm? - OBESITY; what can we do?

A

encourage good exercise and diet!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are some risk factors that can lead to an aneurysm? - PAD in LOWER EXTREMITIES; what can we do?

A

help with this issue; treat this disease; ***INCREASED RISK for developing AORTIC ANEURYSM!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are some risk factors that can lead to an aneurysm? - NON-MODIFIABLE

A
  • family hx
  • age (increased)
  • male
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

TRUE vs FALSE aneurysms

A

TRUE aneurysm = the aneurysm is really there, really outpouching, really dilating, etc.

FALSE aneurysm = artery wall integrity has been interrupted; however, because of the makeup of your body, the bleeding has been contained; not bleeding out!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

True Aneurysm: FUSIFORM

A

FUSIFORM - true = the outpouching is on both sides; balloon like > same shape/symmetrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

True Aneurysm: SACCULAR

A

SACCULAR - true = aneurysm with narrow neck + outpouching on ONE side of artery; looks like a small sack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are some types of false aneurysms?

A
  • trauma
  • infection
  • surgeries
22
Q

can a clot form/block an aneurysm?

A

YES; if a clot forms, keeping the blood inside the artery; this is good; but still concerning because the clot could eventually become dislodged!

23
Q

what are some S/S of thoracic aortic aneurysms?

A
#1: chest pain
#2: stroke like symptoms
#3: pressure of laryngeal nerve
24
Q

what are some S/S of thoracic aortic aneurysms? #1 CHEST PAIN

A
  • **MAJOR S/S OF THORACIC AORTIC ANEURYSM
  • chest pain occurs because there is decreased blood flow to the coronary arteries; the chest pain occurs because the blood isnt getting to the heart muscles like normal!
25
what are some S/S of thoracic aortic aneurysms? #2 STROKE LIKE S/S
stoke like symptoms occur because of transient ischemic attacks due to DECREASED perfusion/blood flow/oxygen to brain and other organs
26
what are some S/S of thoracic aortic aneurysms? #3 PRESSURE OF LARYNGEAL NERVE
-coughing + choking because of laryngeal nerve pressure; increased pressure; swelling in face + arms because of the location of the aneurysm; causes reduced fluid to return = swelling
27
what are some S/S of abdominal aortic aneurysms?
* ***generally asymptomatic and detected during an assessment via palpable mass - palpable mass - bruit heard - back pain (not definitive) - patchy, blue feet/toe syndrome (poor perfusion) - stomach discomfort/bowel issues (actual location of aneurysm)
28
Complications of ruptured aneurysms: retroperitoneal
***MOST SERIOUS COMPLICATION W/ ANEURYSM RETROPERITONEAL rupture: you MIGHT see a bleed in the peritoneal cavity; BUT hopefully/commonly it is controlled by surrounding organs
29
Complications of ruptured aneurysms: thoracic/abdominal
* ***VERY EMERGENT; may lead to death, quickly, because of the quick loss of blood. - NEEDS BLOOD PRODUCTS + FLUIDS + SURGICAL REPAIR; some or all interventions may be necessary due to location/severity.
30
how is an aneurysm diagnosed; what diagnostics are used?
- chest x-ray - abdominal x-ray - ultrasound - CT scan - MRI - angiography
31
how is an aneurysm diagnosed; what diagnostics are used? - CHEST X-RAY
the chest x-ray is used to see if there is any abnormal widening of the aorta
32
how is an aneurysm diagnosed; what diagnostics are used? - ABDOMINAL X-RAY
the abdominal x-ray is used to see if there is any abnormal widening of the aorta
33
how is an aneurysm diagnosed; what diagnostics are used? - ULTRASOUND
the ultrasound is used to screen + detect size of the aneurysm
34
how is an aneurysm diagnosed; what diagnostics are used? - CT SCAN
***GOLD STANDARD for diagnosing an aneurysm! -this helps us detect where the aneurysm is AND how big/diameter of it
35
how is an aneurysm diagnosed; what diagnostics are used? - MRI
the MRI is used for determining the size + location of the aneurysm
36
What should I know, as a nurse, to care for my patient with an aneurysm?
* **GOAL = PREVENT GROWTH & RUPTURE - medications helping with decreased B/P, decreased HR, decreased clotting, etc. ---MEDICAL MANAGEMENT can be used for aneurysms less than 5.4 cm -monitor your patient
37
when is surgical repair needed?
- Aneurysms that are 5.5cm or LARGER may require surgical repair/intervention - aneurysms that are RAPIDLY growing may require surgical repair/intervention - aneurysms that are HIGH RISK FOR RUPTURE may require surgical repair/intervention
38
why surgically intervene?
for aneurysms that require/may require surgical repair, surgery may be preferred because of the ability to resolve it in a controlled environment vs spontaneously >> which can lead to bleeding out/uncontrolled bleeding
39
what is MARFARN SYNDROME?
MARFARN SYNDROME = disease that causes over stretching of the aorta = higher risk for aneurysm! ***INCREASED RISK FOR RUPTURE TOO
40
surgical repair-open abdominal repair (OAR)
- surgical operation - LARGE abdominal incision - cleans up aorta too - places graft in aorta + closes the aorta AROUND graft
41
what does the nurses assessment need to include/look like?
- must obtain a thorough hx + in-depth physical assessment - ensure you know if any atherosclerosis exists - hx of it - OBTAIN BASELINE PULSES, VITALS, RENAL VITALS and NEURO VITALS ----monitor for S/S of RUPTURE
42
What are the post-op GOALS of a patient with an aneurysm?
* *MAINTAIN NORMAL TISSUE PERFUSION - ensure motor/sensory functions are fully intact - ensure no complication have arose from the surgical repair
43
what are some GOALS for POST-OP CARE?
- adequate respiratory function - F&E balance - pain control/reduced pain/increased comfort - graft patency - renal perfusion - cardiac perfusion - NO INFECTION - NO BLOOD CLOTS - NO NEURO PROBLEMS
44
how can you ensure graft patency?
* *ADEQUATE B/P: assess CVP, PA pressure; replace fluid/blood as needed; good/proper hourly urine output - AVOID severe HTN; increased risk for post-op issues **IV diuretics, beta blockers, hydralazine, nitro
45
what changes can we see in cardiovascular status?
* *dysrhythmias: can occur - due to electrolyte imbalances - hypoxemia can occur - hypothermia can occur - MI or ischemia * **MONITOR + REPLACE ELECTROLYTES * **MONITOR EKG + PULSE OX * **FREQUENT ABGs * **ADMINISTER IV anti-dys medications as needed
46
what to do to prevent/treat infections post-op aneurysm repair:
- assess for S/S of infection: fever, indicative labs, etc. * *broad spectrum antibiotics - assess surgical site for: redness, drainage, pain, etc. - ensure good nutrition for proper healing - monitor central lines + foley cath! ----graft infection is RARE
47
what is important to remember/understand about gastrointestinal status after aneurysm repair?
* **HIGH RISK for PERIOP ILLEUS w/ OAR - NG tube placement might be necessary - record I&O - strict monitoring - assess for bowel sounds Q4 hours - ensure patient is passing gas (shows bowels are active/movement is present) - encourage EARLY AMBULATION
48
what can be a bad sign with peripheral pulses?
BAD = cool, pale, mottled skin/extremity + PAINFUL
49
are there any weight bearing restrictions post-op?
NO HEAVY LIFTING FOR 6 weeks post-op
50
what education do I need to give to my post-op patient?
- gradually increase your activity levels; may become fatigued easier/more often - your appetite might be poor for a bit - monitor bowel habits; encourage fluid intake, monitor for constipation - discourage bearing down - educate for S/S of infection at the surgical site - educate how to monitor their own pulses to ensure good perfusion/circulation