ANEURYSMS AND DISSECTIONS at Springfield Technical Community College | Flashcards & Summaries

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Cerebral Aneurysm 

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Risk Factors : hypertension, smoking, genetics 

Symptoms: none until rupture

  • "Worst headache of my life" followed by loss of consciousness 

Complications: 

  • Subarachnoid hemorrhage 
  • If ruptures can cause hemorrhagic stroke 
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Risk factors for Cerebral Aneurysm 

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  • SMoking 
  • Hiypertension 
  • Age over 40 
  • Presense of a AVM ateriovenous malformation 
  • Family history 
  • Cocaine use 
  • Women 
  • Head trauma 
  • Tumors 
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Treatment for SAH

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  • Clipping of the aneurysm- clip stays for life  

or

  • Endovascular coiling - occludes the aneurysm 
  • Nimodipine is a calcium channel blocker given to prevent vasospam 
  • Pt's are kept euvolemic w/ fluid replacement as needed 
  • Hyperdynamic therapy (once safe)
    • Artificially increased BP 
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Aortic Aneurysms 

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Pemanant outpouching or dilation of the vessel wall. 

  • Thoracic: above heart 
  • Abdominal Aortic Aneurysm (AAA): below heart 
  • Saccular or fusiform 
  • Increase risk with age, hypertension, coronary artery disease, family history, artherosclersosis, tobacco use, obesity 
  • More common in men 
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AAA Diagnostic Studies 

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  • CT chest/abdomen
  • MRI chest/abdomen
  • TEE
  • Abdominal ultrasound 


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Abdominal Aneurysm Repair 

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Important to remember... 

  • A complication of AAA is intraabdominal hypertension and abdominal compartment syndrome 
  • Nurse must monitor for post-op complications
    • mental status changes 
    • drop in urine output
    • high or low BP 
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Ambulatory care for post-op AAA Patient

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  • Fatigue, poor appetite, and irregular bowel habits are common. 
  • Pt should avoid heavy lifting for 6 weeks after surgery
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Aortic Dissection

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inner layer 

  • of the aorta tears, blood surges through the tear, causing the inner and middle layers of the vessel to separate (dissect).
  • Classified based on location and duration of onset 
    • Type A
    • Type B
    • Acute (14 day) 
    • Subacute (14-90 days) 
    • Chronic (> 90days)


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Aortic Dissection Types

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Type A - More common and dangerous, tear in heart which may extend to abdomen


Type B - Tear in lower aorta, may extend to abdomen 

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Risk Factors for Aortic Dissection 

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  • Males
  • Weightlifting 
  • Cocaine
  • Pregnancy 
  • Age
  • Uncontrolled high BP

Genetic 

  • Turners syndrome 
  • Marfan syndrome
  • Connective tissue disorders
  • Inflammatory or infectious conditions
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Acute care for Aortic Dissection 

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  • BP<100 and HR<60 and pain management 
  • Reducing the HR , BP and myocardial contractility limits extension of the dissection
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Preop Nursing Management for Aortic Dissection

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  • Semi-Fowlers and quiet environment 
  • this helps to keep HR < 60 and BP <100 
  • Give opioids and sedatives
  • Manage pain and anxiety to prevent extension of dissection 
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Q:

Cerebral Aneurysm 

A:

Risk Factors : hypertension, smoking, genetics 

Symptoms: none until rupture

  • "Worst headache of my life" followed by loss of consciousness 

Complications: 

  • Subarachnoid hemorrhage 
  • If ruptures can cause hemorrhagic stroke 
Q:

Risk factors for Cerebral Aneurysm 

A:
  • SMoking 
  • Hiypertension 
  • Age over 40 
  • Presense of a AVM ateriovenous malformation 
  • Family history 
  • Cocaine use 
  • Women 
  • Head trauma 
  • Tumors 
Q:

Treatment for SAH

A:
  • Clipping of the aneurysm- clip stays for life  

or

  • Endovascular coiling - occludes the aneurysm 
  • Nimodipine is a calcium channel blocker given to prevent vasospam 
  • Pt's are kept euvolemic w/ fluid replacement as needed 
  • Hyperdynamic therapy (once safe)
    • Artificially increased BP 
Q:

Aortic Aneurysms 

A:

Pemanant outpouching or dilation of the vessel wall. 

  • Thoracic: above heart 
  • Abdominal Aortic Aneurysm (AAA): below heart 
  • Saccular or fusiform 
  • Increase risk with age, hypertension, coronary artery disease, family history, artherosclersosis, tobacco use, obesity 
  • More common in men 
Q:

AAA Diagnostic Studies 

A:
  • CT chest/abdomen
  • MRI chest/abdomen
  • TEE
  • Abdominal ultrasound 


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Q:

Abdominal Aneurysm Repair 

A:

Important to remember... 

  • A complication of AAA is intraabdominal hypertension and abdominal compartment syndrome 
  • Nurse must monitor for post-op complications
    • mental status changes 
    • drop in urine output
    • high or low BP 
Q:

Ambulatory care for post-op AAA Patient

A:
  • Fatigue, poor appetite, and irregular bowel habits are common. 
  • Pt should avoid heavy lifting for 6 weeks after surgery
Q:

Aortic Dissection

A:

inner layer 

  • of the aorta tears, blood surges through the tear, causing the inner and middle layers of the vessel to separate (dissect).
  • Classified based on location and duration of onset 
    • Type A
    • Type B
    • Acute (14 day) 
    • Subacute (14-90 days) 
    • Chronic (> 90days)


Q:

Aortic Dissection Types

A:

Type A - More common and dangerous, tear in heart which may extend to abdomen


Type B - Tear in lower aorta, may extend to abdomen 

Q:

Risk Factors for Aortic Dissection 

A:
  • Males
  • Weightlifting 
  • Cocaine
  • Pregnancy 
  • Age
  • Uncontrolled high BP

Genetic 

  • Turners syndrome 
  • Marfan syndrome
  • Connective tissue disorders
  • Inflammatory or infectious conditions
Q:

Acute care for Aortic Dissection 

A:
  • BP<100 and HR<60 and pain management 
  • Reducing the HR , BP and myocardial contractility limits extension of the dissection
Q:

Preop Nursing Management for Aortic Dissection

A:
  • Semi-Fowlers and quiet environment 
  • this helps to keep HR < 60 and BP <100 
  • Give opioids and sedatives
  • Manage pain and anxiety to prevent extension of dissection 
ANEURYSMS AND DISSECTIONS

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