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AAA- anerysm
pn 141 test 1 book: med surg nursing pg 677
| Question | Answer |
|---|---|
| Def of an aneurysm | weakness and localized dilation of a blood vessel wall |
| why do they usually effect the aorta | because there is high pressure with in these vessels |
| what is the usual cause | arteriosclerosis and atherosclerosis |
| def of fusiform anerurysms | involves the entire circumference of the vessel, they grow slowly an progressively |
| def of saccular aneurysm | involves only a portion of the vessel, associated with congenital malformations or syphilis |
| def of aortic dissection (aka dissecting aneurysm) | they develop due to the weakening of the medial layer of the aorta, blood leaks into the vessel wall and separates the innermost layer of the artery from the outermost |
| aortic dissection where does this usually occur | in the ascending aorta |
| do aneurysms have s/s | no |
| when are the usually Dx | during routine physical exams |
| why do s/s usually occur | they uccur due to the pressure of the aneurysm on the adjacent tissues and organs |
| what is the AAA associated with | arteriosclerosis, HTN, smoking, and increasing age |
| at what age are they normally found | in ppl >70 |
| What is found upon examination | a pulsating mass in the mid an upper abdomen and a bruit over the mass |
| what may the pt c/o | severe mid abdominal or lowe back pain |
| the degree of pain usually indicated what | the severity and urgency of the problem, because pain can be an indication of an impending rupture |
| s/s of a AAA | pulsating abdominal mass, abdominal or lower back pain, cool pale or cyonotic lower extremities |
| complications of a AAA | emboli to lower extremities, rupture or hemmorage |
| marfans syndrome: what is it | a connective tissue disorder with three distinctive features (1- long, thin extremities, hyperextendable joints 2- impaired vision 3- CV defects, mitral valve prolapse and weakness of the aorta |
| what diagnostic test can detect them | a chest or abdminal x-ray |
| why us a ct or mri done | to measure the size of the AAA |
| meds given: why are antihypertenisives given | to decrease BP |
| meds given: why are anticoagulants given | started to prevent an emboli and after a surgical repair of one |
| surgery: when is it done | to repair aneurysms that are tender to palpation or enlarging |
| Surgery: what is done | the aneurysm is excised and a graft is placed. Clamps are placed above and below the vessel dilation while surgery is performed |
| Nursing care after surgery: what are s/s of graft leakage | bruising of scrotum, penis, hematoma in incision, increased abdominal girth, weak or absent peripheral pulses, decreased bp, increased abdom. pain, decreased BP, drop in HCT or HGB |
| complications of AAA surgery | lower extremity embolism, bowel ischemia, impaired renal function, spinal cord ischemia |
| when is surgery done (how large in diameter does it have to be | >5 cm |
| does aneuryms usually occur above or below the kidneys | below |
| s/s of necrotic bowel | no bs, hard abdomen, pain, blood in diarrhea |
| what is used to relieve pain post op | epidural; this help with c&DB |
| why does HTN need to be under control after surger y | b/c of new graft (don't want it to rupture) |
Created by:
jmkettel
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