aortic aneurysm

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Author:
Anonymous
ID:
8638
Filename:
aortic aneurysm
Updated:
2010-03-01 13:20:15
Tags:
meg surg IV RN
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Description:
aortic aneurysm care
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  1. DEFINE
    aortic aneurysm
    outpouchings or dilations of the arterial wall and are common
  2. PATHOPHYSIOLOGY OF:
    • aneurysms of the descending and abdominal aorta is atherosclerosis.
    • Atherosclerotic plaques deposit beneath the intima. Plaque formation causes degenerative changes in the middle layer of the arterial wall. leading to loss of elasticity, weakening, and eventual aortic dilation.
    • congenital
    • blunt trauma
    • inflammatory aortitis
    • infectious aortitis
  3. CLASSIFICATIONS OF
    (hint 2)
    • TRUE - the artery wall forms the aneurysm, vessell layer still intact
    • -fusiform uniform outpouching
    • -saccular - pouch like w/ a narrow neck on one side of the wall
    • FALSE - not aneurysm but diruption of all layers of the arterial wall
    • -bleeding
    • -ruptures
    • -catheter tares
  4. CLINICAL MANIFESTATIONS
    asymptomatic

    • deep,diffuse chest pain radiates to interscapular area
    • angina - from disruption of blood flow
    • hoarsness - pressure upon laryngeal nerve
    • dysphagia - pressure on esphagus
    • distended neck veins, swelling edema head and arms - pressure on the superior vena cava r/t decreased venous return.

    • pulsatile mass - periumbilical area
    • bruits - by auscultation

    • AAA - mimic abd. or back pain
    • - blue toe syndrome - patchy mottling of feet and toes w/ palpable pedal pulses
  5. SURGICAL MANAGEMENT
    perioperative - pt is hydrated, electrolytes balanced, coagulation monitored, hematocrits WNL.

    • OR - if rupture - emergent surgical repair 33-94% mortality
  6. SURGICAL TECHNIQUES
    • 1. incising the diseased segment
    • 2. removing intraluminal thrombus or plaque
    • 3. inserting a synthetic graft
    • 4. suturing the native aortic wall around the graft as a protective cover
  7. DIAGNOSTIC STUDIES FOR AA
    • X-RAY
    • ECG R/O MI
    • ECHOCARIOGRAPHY - diagnsis of aortic valve insufficiency
    • U/S - aneurysm size
    • CT - most accurate for size and thrombus presence
    • MRI - if indicated

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