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Abdominal Aortic Aneurysm Nursing Care Plan & Management

Notes

Description
  • An aortic aneurysm is an irorderly dilation of the arterial forbearance purposed by localized debility and stretching in the resourcesl layer or forbearance of an artery.
  • The aneurysm can be located anywclose concurrently the abdominal aorta.
  • The sight of matter is to era the gradation of the illness by modifying lavish contents , regulateling the BP to intercept deputrounce on the aneurysm, recognizing concomitants offer, and intercepting tearing.
Assessment
  1. Prominent, pulsating heap in abdomen, at or aloft the umbilicus
  2. Systolic ventilate aggravate the aorta
  3. Tenderness on characterfelt palpation
  4. Abdominal or inferior end suffering
Diagnostic Evaluation
  1. Chest radiograph, angiogram, transesophageal echocardiography, and magnetic resonance imaging(MRI).
  2. Duplex ultrasonography or computed tomography (CT)
Primary Nursing Peculiarity
  • Risk for running body insufficiency akin to hemorrhage
Other Diagnoses that may arise in Nursing Wariness Plans For Abdominal Aortic Aneurysm
  • Acute suffering akin to surgical edifice trauma
  • Anxiety akin to browbeating to characteriness foothold
  • Decreased cardiac output akin to:
    • changes in intravascular body
    • increased classificationic vascular resistance
    • third-interspace running shift
  • Deficient recognition (preoperative and postoperative wariness) akin to newly attested want for aortic surgery
  • Ineffective subsisting sample akin to:
    • effects of public anesthesia
    • endotracheal intubation
    • closeness of an abdominal incision
Medical Management
Medical or surgical matter depends on the emblem of aneurysm. For a tearing aneurysm, prognosis is meagre and surgery is produced straightly. When surgery can be delayed, medical measures include:
  • Strict regulate of respect influence and diminution in pulsatile run.
  • Systolic influence maintained at 100 to 120 mm Hg delay antihypertensive drugs, such as nitroprusside.
  • Pulsatile run base by medications that refer cardiac contractility, such as propanolol.
Surgical Management
  • Removal of the aneurysm and renewal of vascular uninterruptedness delay a parte (resection and bypass parte or endovascular parteing) is the sight of surgery and the matter of dainty for abdominal aortic aneurysms larger than 5.5 cm (2 inches) in transection or those that are enlarging. Intensive monitoring in the exact wariness part is insist-upond.
Nonsurgical Intervention
  1. Modify lavish contents.
  2. Instruct the client touching the act for monitoring BP.
  3. Instruct the client on the weight of orderly physician marks to thrive the bulk of the aneurysm.
  4. Instruct the client that if cutting end or abdominal suffering or repletion, soreness aggravate the umbilicus, quick product of stain in the extremities, or a perennial altitude of BP arises to warn the physician straightly.
  5. Instruct the client delay a thoracic aneurysm to description straightly the ariserence of chest or end suffering, absence of inspiration, awkwardness gluttony, or hoarseness.
Pharmacologic Highlights
  1. 1-10 mg IV of opioid analgesic (morphine) to succor surgical suffering.
  2. 50–100 mcg IV of opioid analgesic (Fentanyl) to succor surgical suffering.
  3. Antihypertensives and/or diuretics for promotion BP may strain parte union cords.
  4. 80-400 mg/day in portio doses of Beta blocker (propanolol) to use in nation delay narrow aneurysms delayout lavish for tearing; decreases trounce of AAA dilution
Nursing Intervention
  1. Monitor animate presages.
  2. Assess lavish contents for the arterial illness regularity.
  3. Obtain notification touching end or abdominal suffering.
  4. Question the client touching the surprise of palpation in the abdomen.
  5. Inspect the husk for the closeness of vascular illness or breakdown.
  6. Check peripheral prevalence, including pulses,temperature, and perversion.
  7. Observe for presages of tearing.
  8. Note any mildness aggravate the abdomen.
  9. Monitor for abdominal distention.
Documentation Guidelines
  • Location,intensity,and abundance of suffering,and the contents that succor suffering
  • Appearance of abdominal injure (color,temperature,intactness,drainage)
  • Evidence of uprightness of animate presages,hydration foothold,bowel probes,electrolytes
  • Presence of complications: Hypotension, hypertension, cardiac dysrhythmias, low urine out- put,thrombophlebitis,infection,unite termination,changes in perception,aneurysm tearing, inordinate heedfulness,meagre injure healing
Discharge and Home Healthwariness Guidelines
  1. Wound wariness. Explain the want to heed the surgical injure spotless and dry. Teach the enduring to heed the injure and description to the physician any acceptiond turgescence,redness,drainage,odor,or disconnection of the injure edges. Also teach the enduring to warn the physician if a broil develops.
  2. Activity restriction. Teach the enduring to erect rush heavier than 5 pounds for encircling 6 to 12 weeks and to abandon driving until her or his physician permits. Braking opportunity driving may acception intra-abdominal influence and dismember the union cord. Most surgeons temporarily intimidate activities that insist-upon pulling, intermeddling, or stretching—activities such as vacuuming,changing sheets,easy tennis and golf,mowing grass,and chopping thicket.
  3. Smoking plugping. Encourage the enduring to plug smoking and to involve smoking plugping classes.
  4. Complications thriveing surgey. Discuss delay the enduring the possibility of clot shape or parte blockage.
  5. Complicatios for endurings not requiring surgery. Compliance delay the regime of monitoring the bulk of the aneurysm by computed tomography aggravate era is adventitious. The enduring wants to learn the prescribed medication to regulate hypertension. Advise the enduring to description abdominal repletion or end suffering,which may point-out a pending tearing.
References: ADAM for images Saunders, Comprehensive Resight for the NCLEX_RN Exam , 2005 ed Marilyn Sawyer Sommers, RN, PhD, FAAN , Susan A. Johnson, RN, PhD, Theresa A. Beery, PhD, RN , DISEASES AND DISORDERS A Nursing Therapeutics Manual, 2007 3rd ed

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