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    Abdominal Aortic Aneurysm

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    yabaeve
    An abdominal aortic aneurysm is an abnormal dilation of the aorta in the abdomen. Risk factors include hypertension, smoking, and family history. Symptoms may include a pulsating abdominal mass, back pain, or tenderness. Diagnosis is made through imaging tests like ultrasound or CT scan. Treatment depends on size, but includes controlling blood pressure, medications to reduce strain, and surgery for large or expanding aneurysms by removing and replacing the damaged section of aorta. Post-op care focuses on wound monitoring, activity restrictions, and smoking cessation to prevent complications.

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    Abdominal Aortic Aneurysm

    Uploaded by

    yabaeve
    581 views3 pages
    An abdominal aortic aneurysm is an abnormal dilation of the aorta in the abdomen. Risk factors include hypertension, smoking, and family history. Symptoms may include a pulsating abdominal mass, back pain, or tenderness. Diagnosis is made through imaging tests like ultrasound or CT scan. Treatment depends on size, but includes controlling blood pressure, medications to reduce strain, and surgery for large or expanding aneurysms by removing and replacing the damaged section of aorta. Post-op care focuses on wound monitoring, activity restrictions, and smoking cessation to prevent complications.

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    An abdominal aortic aneurysm is an abnormal dilation of the aorta in the abdomen. Risk factors include hypertension, smoking, and family history. Symptoms may include a pulsating abdominal mass, back pain, or tenderness. Diagnosis is made through imaging tests like ultrasound or CT scan. Treatment depends on size, but includes controlling blood pressure, medications to reduce strain, and surgery for large or expanding aneurysms by removing and replacing the damaged section of aorta. Post-op care focuses on wound monitoring, activity restrictions, and smoking cessation to prevent complications.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    581 views3 pages

    Abdominal Aortic Aneurysm

    Uploaded by

    yabaeve
    An abdominal aortic aneurysm is an abnormal dilation of the aorta in the abdomen. Risk factors include hypertension, smoking, and family history. Symptoms may include a pulsating abdominal mass, back pain, or tenderness. Diagnosis is made through imaging tests like ultrasound or CT scan. Treatment depends on size, but includes controlling blood pressure, medications to reduce strain, and surgery for large or expanding aneurysms by removing and replacing the damaged section of aorta. Post-op care focuses on wound monitoring, activity restrictions, and smoking cessation to prevent complications.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 3
    At a glance
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    The key takeaways are that an abdominal aortic aneurysm is an abnormal dilation of the aorta caused by weakness in the arterial wall. The goal of treatment is to limit progression and prevent rupture by controlling risk factors and blood pressure. Surgery is the treatment of choice for aneurysms larger than 5.5 cm in diameter or those that are enlarging.

    Signs and symptoms of an abdominal aortic aneurysm include a prominent pulsating mass in the abdomen above the umbilicus, a systolic bruit over the aorta, tenderness on deep palpation of the abdomen, and abdominal or lower back pain.

    Diagnostic tests used to evaluate an abdominal aortic aneurysm include chest x-rays, angiograms, transesophageal echocardiography, MRI, duplex ultrasonography, and CT scans.

    Abdominal Aortic Aneurysm

    Description
    • An aortic aneurysm is an abnormal dilation of the arterial wall caused by localized
    weakness and stretching in the medial layer or wall of an artery.
    • The aneurysm can be located anywhere along the abdominal aorta.

    • The goal of treatment is to limit the progression of the disease by modifying risk factors ,
    controlling the BP to prevent strain on the aneurysm, recognizing symptoms early, and
    preventing rupture.

    Assessment
    1. Prominent, pulsating mass in abdomen, at or above the umbilicus
    2. Systolic bruit over the aorta
    3. Tenderness on deep palpation
    4. Abdominal or lower back pain

    Diagnostic Evaluation
    1. Chest radiograph, angiogram, transesophageal echocardiography, and magnetic
    resonance imaging(MRI).
    2. Duplex ultrasonography or computed tomography (CT)

    Primary Nursing Diagnosis


    • Risk for fluid volume deficit related to hemorrhage

    Medical Management
    Medical or surgical treatment depends on the type of aneurysm. For a rupture aneurysm,
    prognosis is poor and surgery is performed immediately. When surgery can be delayed, medical
    measures include:
    • Strict control of blood pressure and reduction in pulsatile flow.
    • Systolic pressure maintained at 100 to 120 mm Hg with antihypertensive drugs, such as
    nitroprusside.
    • Pulsatile flow reduced by medications that reduce cardiac contractility, such as
    propanolol.

    Surgical Management
    • Removal of the aneurysm and restoration of vascular continuity with a graft (resection
    and bypass graft or endovascular grafting) is the goal of surgery and the treatment of
    choice for abdominal aortic aneurysms larger than 5.5 cm (2 inches) in diameter or those
    that are enlarging. Intensive monitoring in the critical care unit is required.

    Nonsurgical Intervention
    1. Modify risk factors.
    2. Instruct the client regarding the procedure for monitoring BP.
    3. Instruct the client on the importance of regular physician visits to follow the size of the
    aneurysm.
    4. Instruct the client that if severe back or abdominal pain or fullness, soreness over the
    umbilicus, sudden development of discoloration in the extremities, or a persistent
    elevation of BP occurs to notify the physician immediately.
    5. Instruct the client with a thoracic aneurysm to report immediately the occurrence of chest
    or back pain, shortness of breath, difficulty swallowing, or hoarseness.

    Pharmacologic Highlights
    1. 1-10 mg IV of opioid analgesic (morphine) to relieve surgical pain.
    2. 50–100 mcg IV of opioid analgesic (Fentanyl) to relieve surgical pain.
    3. Antihypertensives and/or diuretics for rising BP may stress graft suture lines.
    4. 80-400 mg/day in divide doses of Beta blocker (propanolol) to use in people with small
    aneurysms without risk for rupture; decreases rate of AAA expansion

    Nursing Intervention
    1. Monitor vital signs.
    2. Assess risk factors for the arterial disease process.
    3. Obtain information regarding back or abdominal pain.
    4. Question the client regarding the sensation of palpation in the abdomen.
    5. Inspect the skin for the presence of vascular disease or breakdown.
    6. Check peripheral circulation, including pulses,temperature, and color.
    7. Observe for signs of rupture.
    8. Note any tenderness over the abdomen.
    9. Monitor for abdominal distention.

    Documentation Guidelines
    • Location,intensity,and frequency of pain,and the factors that relieve pain
    • Appearance of abdominal wound (color,temperature,intactness,drainage)

    • Evidence of stability of vital signs,hydration status,bowel sounds,electrolytes

    • Presence of complications: Hypotension, hypertension, cardiac dysrhythmias, low urine


    out- put,thrombophlebitis,infection,graft occlusion,changes in consciousness,aneurysm
    rupture, excessive anxiety,poor wound healing

    Discharge and Home Healthcare Guidelines


    1. Wound care. Explain the need to keep the surgical wound clean and dry. Teach the
    patient to observe the wound and report to the physician any increased
    swelling,redness,drainage,odor,or separation of the wound edges. Also instruct the patient
    to notify the physician if a fever develops.
    2. Activity restriction. Instruct the patient to lift nothing heavier than 5 pounds for about 6 to
    12 weeks and to avoid driving until her or his physician permits. Braking while driving
    may increase intra-abdominal pressure and disrupt the suture line. Most surgeons
    temporarily discourage activities that require pulling, pushing, or stretching—activities
    such as vacuuming,changing sheets,playing tennis and golf,mowing grass,and chopping
    wood.
    3. Smoking cessation. Encourage the patient to stop smoking and to attend smoking
    cessation classes.
    4. Complications following surgey. Discuss with the patient the possibility of clot formation
    or graft blockage.

    5. Complicatios for patients not requiring surgery. Compliance with the regime of
    monitoring the size of the aneurysm by computed tomography over time is essential. The
    patient needs to understand the prescribed medication to control hypertension. Advise the
    patient to report abdominal fullness or back pain,which may indicate a pending rupture.

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