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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Risk for Decreased Cardiac Output

Nursing Diagnosis

May be related to

  • Progressive dissection
  • Rupture of the aorta
  • Side effects of medications

Possibly evidenced by

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  • [not applicable]

Desired Outcomes

  • Client will maintain adequate cardiac output, as evidenced by HR of 60 to 100 beats per minute, normotensive BP, palpable pulse, clear lung sounds, urine output more than 30 ml/hr, and normal level of consciousness.
Nursing InterventionsRationale
Asess for signs of myocardial ischemia: chest pain, tachycardia, or ST-segment and T-wave changes on electrocardiogram (ECG).ECG changes help guide the timing of interventions.
Assess the client’s hemodynamic status. Monitor for signs of decreasing cardiac output, such as tachycardia, decreased urine output, and restlessness.A dissecting abdominal aortic aneurysm (AAA) is the most common catastrophe involving the aorta, and it has a high mortality rate if not detected early and treated with surgery. Clients with decreasing or rupturing aneurysm are hemodynamically compromised. Early evaluation of warning signs facilitates prompt intervention.
If decreased cardiac output is related to further dissection (severe aortic insufficiency) or ruptured aorta, anticipate emergency angiography and surgeryRapid, efficient intervention is critical to preserve circulation and life
These maintain adequate cardiac output before surgical intervention.
  • Stay with the client.
The presence of a competent, calm staff may provide emotional support and reduce fear.
  • Send a blood specimen for type and crossmatch and other routine preoperative blood work.
Blood replacement therapy may be required to maintain effective blood volume.
  • Prepare the client for surgical repair.
Information helps to allay anxiety. Clients who are anxious may not be able to comprehend anything more than simple, brief instructions and explanations.
If decreased cardiac output is drug induced, anticipate the following:
  • For beta-blocker: May stop the drug or reduce the dose.
Beta-blockers have a negative inotropic effect, which can potentiate heart failure. The presence of crackles and S3 indicates heart failure.
Fluids are usually required to maintained increased intravascular volume.
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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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