4 Aortic Aneurysm Nursing Care Plan

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Aortic aneurysm (Abdominal Aneurysm; Dissecting Aneurysm; Thoracic Aneurysm;) is a localized, circumscribed, blood-filled abnormal dilation of an artery caused by disease or weakening of the vessel wall.

True aneurysms involve dilation of all layers of the vessel wall. The two types of true aneurysms are: (1) saccular, which is characterized by a bulbous out-pouching of one side of the artery resulting in localized stretching in localized stretching of the artery wall, and (2) fusiform, which is characterized by a uniformly shaped dilation of the entire circumference of the artery. True aneurysms are asymptomatic and are typically diagnosed by physical examination or a diagnostic ultrasound or computed tomography (CT) scan. The natural history of an aneurysm is enlargement; as a rule, the larger it is, the greater the chance of rupture. Aneurysms are most commonly seen in the abdominal aorta. Abdominal aortic aneurysm (AAAs) account for about 75% and thoracic aneurysms for about 25% of all cases. They occur more often in men than in women. Risk factors include smoking and familial history of aneurysms. When an aneurysm becomes large enough for risk for rupture, it can be repaired by open surgical repair or a less-invasive endograft-covered stent repair.

Dissecting aneurysms occur when the inner layer of the blood vessel wall tears and splits, creating a false channel and cavity of blood between the intimal and adventitial layers. They are typically classified according to the location. According to the Stanford classification, type A involves the ascending aorta and its transverse arch and type B involves the descending aorta. A dissecting AAA is the most catastrophe involving the aorta, and it has a high mortality rate if not detected early and treated with surgery. More than 90% of clients present with sudden onset of severe pain which is usually described, as sharp, tearing, or stabbing in nature. Symptoms depend on the size and location of the dissection or rupture. Risk factors for dissection include congenital, inflammatory, hypertension, pregnancy, trauma, and Marfan syndrome.

Nursing Care Plans

Nursing care plan for clients with an aortic aneurysm is to modify risk factors, controlling the BP to prevent strain on the aneurysm, recognizing symptoms early, and preventing the occurrence of a rupture.

Here are four (4) nursing care plans (NCP) and nursing diagnosis for patients with aortic aneurysm:

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  1. Anxiety
  2. Deficient Knowledge
  3. Risk for Decreased Cardiac Output
  4. Risk for Ineffective Tissue Perfusion
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Deficient Knowledge

Nursing Diagnosis

May be related to

  • New medical problem
  • Unfamiliarity with surgical procedure and hospital care

Possibly evidenced by

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  • Expressed need for information
  • Multiple questions

Desired Outcomes

  • Client or significant others verbalize understanding of disease process, treatment options, and goals of therapy.
Nursing InterventionsRationale
Assess the client’s knowledge of the disease and treatment options.This information provides an important starting point in education.
Instruct medically treated clients about the following:

  • Goals of therapy (avoidance of excess BP and strain on the disease arterial wall)
  • Importance of follow-up computed tomography scanning
  • Signs and symptoms to report
  • Side effects of the drug
  • Use of antihypertensive medications as prescribed; importance of compliance
Clients treated medically need to maintain goal BP levels and comply with scheduled CT scans to monitor the size of the aneurysm. Knowledge of early warning signs facilitates rapid treatment. These may include pain in the chest, back, groin, abdomen; decreased urine output; cool, pale extremities.
Instruct surgical clients about the following:

  • Activity restrictions
  • Avoidance activities that are isometric or abruptly can raise BP (e.g., lifting and carrying of heavy objects, straining for bowel movements)
  • Signs and symptoms to report
  • Wound care
Discharge instructions guide clients regarding self-care measures; Heavy lifting of more than 5 to 10 pounds is restricted for 4 to 6 weeks after surgical repair of an aortic aneurysm. These restrictions reduce strain on suture lines until they are completely healed; Clients need to be aware of the warning signs that warrant medical attention.
Instruct endograft clients about the need for follow-up CT scans at 1 and 6 months and yearly for the rest of their lives.The endograft may incur a leak; ongoing evaluation is needed so appropriate treatment can be initiated.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

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Other care plans for hematologic and lymphatic system disorders:

Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
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