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:

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

Anxiety
Anxiety: Vague uneasy feeling of discomfort or dread accompanied by an autonomic
response.

May be related to

 Close monitoring by medical or nursing staff

 Fear of death
 Impending surgery
 Multiple tests and procedures
 Sudden onset of illness
Possibly evidenced by

 Constant demands
 Increased alertness
  Increased questioning
 Restlessness
 Request to have family at bedside all the time
 Tense, anxious appearance
Desired Outcomes

 Client will verbalize strategies to reduce his anxiety level.

 Client will demonstrate positive coping method.
Nursing Interventions Rationale

Aortic dissection and/or rupture can result in an

Assess the client’s anxiety level (mild,
acute life-threatening situation that will produce high
severe). Note signs and symptoms,
levels of anxiety in the client as well as in significant
especially nonverbal communication.
others.

Acknowledgement of the client’s feelings validates

Acknowledge awareness of the client’s
the feelings and communicates acceptance of those
anxiety.
feelings.

Provide a quiet, private place for

A quiet environment can reduce anxiety.
significant others to wait.

Anxiety may escalate with excessive conversation,

Reduce unnecessary external stimuli.
noise, and equipment around the client.

Information helps allay anxiety. Clients who are

Explain all procedures as appropriate,
anxious may not be able to comprehend anything
using simple, concrete words.
more than simple, clear, brief instructions.