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23 Cards in this Set
- Front
- Back
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what is a true aneurysm?
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the wall of the artery forms the aneurysm. one layer of the vessel layer is still intact
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what is a fusiform aneurysm?
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a true aneurysm- circumfrerential and uniform in shape - buldges out
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what is a savvular aneurysm?
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a true aneurysm- pouchlike; narrow neck connects the bulge to the arterial wall- pouches to one side
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what is a false aneurysm?
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not an aneurysm but rupture of ALL the layer of the arterial wall resulting in bleeding that is contained by surrounding structures, usually a hole
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s/s of thoracic abdominal aneurysm?
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-chest pain, shortness of breath
-difficulty swallowing or hoarseness -cough -head and neck edema(back up causes inc. pressure)- due to pressure on the superior vena cava and decreased drainage -may have pain at rest or just while lying down |
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what are clinical manifestations of ascending aorta?
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aortic regurgitation
heart failure |
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what are clinical manifestations of superior vena cava?
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edema of face, neck and arms
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what are s/s of an abdominal aortic aneurysm
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-back pain
-pain on other abdominal structures -Gi discomfort - N/V/cramps -often asymptomatic -will hear bruit - may also but a pulsation in the abdominal area |
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skills and technology for aneurys
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surgical- removal and graft
-always mark peripheral pulses before surgery because they will be hard to find afterwards |
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complications of a surgical repair?
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rupture
severe back pain back or flank ecchymosis (grey turner's sign) |
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dissecting aneurysm
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-tearing of the innermost lining of the aterial wall forming a false lumen- starts tearing
-will hear rip -heart pulses and bp rises, there is inc pressure applied to are cuasing further dissecction |
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risk factors for a dissecting aneurysm are?
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-older males (40-80)
-chronic htn -marfan syndrom (premature degeneration of the vascular elasticity) -blunt trauma |
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what are clinical manifestations of dissecting aneurysms?
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-sudden, severe and persistent tearing or ripping pain in the chest or back
-syncope or altered Loc -paralysis of lower extremeties (b/c no blood supply) -pallor, diaphoresis -cardiovascular, neuro, and resp signs -BP and pulse may be significantly different between left and right arms if the subclavian artery is involved |
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what are possible complications of an aortic dissection?
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cardiac tamponade
hemorrhage ischemia to spinal cord renal ischemia abdominal ischemia |
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diagnostic tests used to find aneurysms?
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-cxr
-ekg -ct &mri -angiography -ultrasound |
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health assessments for an aneurysm?
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-risk factors and hx
-pain -circulation and tissue perfusion -neuro status & loc -renal function -abdominal bruits or pulsations |
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aneurysm symtpom management and morbidity reduction?
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quiet enviornment and bed rest
semi-fowlers position: to keep bp low enough for just organ perfusion |
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post- surgical aneurysm management
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priority intervention is to reduce and maintain systolic bp between 100-200
-hemodynamic monitoring -graft patency circulation & periph pulses -resp distress/dysrhythmias -gi status -infection -neuro status -peripheral perfusion status |
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med management for aneurysms
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-iv antihypertensives (nipride)
-diuretics -narcotics for pain -antiaxiolytics -antidysrhthmics -antiobiotics -anticoags |
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discharge teaching for a pt w/ an aneurysm
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-pt/family apprehensive- calm fears
-adl/activity -blood pressure control (meds) -smoking cessation -encourage low-fat, low cholesterol diet -review s/s of a rupture -avoid heaving lifting for 4-6 weeks -review s/s infection -vascular changes in extremeties -sexual dysfunction |
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what are possible nursing diagnosis for an aneurysm pt?
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-ineffective tissue perfusion
-impaired skin integrity -dec CO -anxiety -deficient knowledge -acute pain -ineffective therapeutic regimen mgmt -activity intolerance |
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surgical procedure for an aneurysm
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clamp above and below aneurysm- so only take 30 minutes- cannot take longer than 40
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if a surgical procedure takes longer than 40 minutes what will happen to the pt?
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renal failure
potential paralysis in lower extremeties |
