Aortic Aneurysm

Question 1

what does the aorta do

Answer 1

responsible for supplying oxygen and nutrients to all vital organs

Question 2

aortic aneurysm

Answer 2

permanent, localized, out pouching, or dilation of wall of aorta

Question 3

different types of aortic aneurysms

Answer 3

abdominal aortic aneurysm; thoracic aorta aneurysm; ascending aorta/aortic arch

Question 4

abdominal aortic aneurysm

Answer 4

3/4 occur in abdominal; 1/4 occur in thoracic; most occur below renal arteries; the larger aneurysm, the greater risk of rupture

Question 5

clinical manifestations of abdominal aortic aneurysms

Answer 5

pulsatile mass in periumbilical area slightly left of midline bruit auscultated over aneurysm; may mimic pain associated with abdominal or back disorders; may cause back pain, epigastric discomfort, altered bowel elimination, intermittent claudication; may spontaneously embolize plague

Question 6

where might an AAA show up on a routine physical?

Answer 6

CT scan, abdominal x-ray

Question 7

clinical manifestations of thoracic aortic aneurysm

Answer 7

deep diffuse chest pain, pain may extend to intrascapular area

Question 8

clinical manifestations of ascending aorta/aortic arch

Answer 8

angina, transient ischemic attacks; coughing SOB, hoarseness, and/or dysphagia

Question 9

what happens if an ascending aorta/aortic arch presses on the superior vena cava

Answer 9

decrease in venous return which results in distended neck veins and edema of the face and arms

Question 10

risk factors for aortic aneurysms

Answer 10

age; male gender; family history; hypertension; CAD; tobacco use; high cholesterol; lower extremity PAD; carotid artery disease; previous stroke; excess weight/obesity

Question 11

complications from aortic aneurysms

Answer 11

ruptures into the retroperitoneal space or thoracic/abdominal cavity; thrombus formation

Question 12

complications from ruptures into retroperitoneal space

Answer 12

bleeding; severe back pain; may/may not have back/flank ecchymosis (Grey Turner’s sign)

Question 13

complications from ruptures into thoracic/abdominal cavity

Answer 13

massive hemorrhage causes hypovolemic shock; most don’t survive long enough to get to the hospital; if patient survives, need simultaneous resuscitation and immediate surgery

Question 14

diagnostic studies for aneurysms

Answer 14

chest and abdomen x-rays; ECG (to rule out MI); echocardiogram; ultrasonography; CT/MRI scan; angiography

Question 15

nursing assessment for aneurysms

Answer 15

history and physical; watch for signs of cardiac, pulmonary, cerebral, and lower extremity vascular problems; establish baseline; assess for signs of rupture; mark/document pedal pulses

Question 16

nursing goals for aneurysms

Answer 16

normal tissue perfusion; intact motor and sensory function; no complications r/t surgical repair (thrombosis, infection, rupture)

Question 17

nursing patient-centered care

Answer 17

vital signs; assess pain, ROM; monitor ABG, O2, electrolytes, and CBC; monitor infection and neurological status; control BP with antihypertensives

Question 18

therapeutic procedures for aneurysms

Answer 18

abdominal aortic aneurysm resection; thoracic aortic aneurysm repair

Question 19

nursing implementation with ambulatory care for aneurysms

Answer 19

encourage patient to express concerns; instruct patient to gradually increase activities; NO HEAVY LIFTING FOR 6 WEEKS; teach s/s of complications

Question 20

what kind of concerns do we want a patient with aneurysms to express?

Answer 20

fatigue; poor appetite; irregular bowel habits; male sexual dysfunction