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AORTIC ANEURYSM
Definition:
○ An aneurysm is an abnormal dilation of a blood vessel commonly at a site of a weakness or
tear in the vessel
○ Aneurysm mostly affects the aorta and peripheral arteries because of increased pressure in
these vessels
○ Aneurysm occur more often in men than women and their incidence increases with age

CLASSIFICATION
Aneurysm is divided into two
types and these are
○ True: this is where aneurysm forms with at least one layer of vessel still intact
○ False (pseudoaneurysm) : is not aneurysm but a disruption of all layers of the arterial wall
resulting in rupture
True aneurysm can be further
divided into :
○ Fusiform- circumferential and relatively uniform in shape
○ Saccular- pouch-like with a narrow neck

ETIOLOGY
○ Congenital
○ Traumatic
○ Inflammatory
○ Mechanical
○ Infectious
○ Pregnancy-related degenerative ○ anastomotic and graft aneurysm
○ in normal cases the aorta is made up of structural proteins called collagen and elastin
○ Collagen provides tensile strength while elastin recoils after systole
○ Aneurysm form due to the weakness of the arterial wall
○ Aneurysms occur from the abnormal dilatation and rupture of the aorta due to the
destruction of elastin and collagen in its wall
○ Aneurysm also occur due to hypertension and long-term eroding atherosclerosis

CLINICAL MANIFESTATIONS
○ Dyspnea
○ Hoarseness and dysphagia
○ Edema of the face and the neck
○ Distended neck veins
○ Back, neck or substernal pains
○ Mild to severe mid-abdominal
and lumbar back pain

MEDICAL MANAGEMENT
Diagnostic studies
○ Chest X-ray to visualize thoracic aortic aneurysm
○ Abdominal Ultrasonography to diagnose abdominal aortic aneurysm
○ Contrast -enhanced CT that allows precise measurement of the aneurysm
○ ECG may be performed to rule out evidence of myocardial infarction
Medications
○ Beta -blockers e.g. propranolol that control the myocardial contractility

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○ Anti-hypertensives e.g. nifedipine
○ Surgery

NURSING MANAGEMENT
Nursing assessment
○ Thorough history and physical assessment should be performed.
○ The nurse should watch for signs of cardiac, pulmonary, cerebral, and lower extremity
vascular problems
Nursing assessment
○ The nurse should monitor the patient for indications of aneurysm rupture such as
diaphoresis, paleness, weakness, tachycardia, hypotension and abdominal pain

NURSING DIAGNOSIS
○ Altered comfort; pain related to inflammatory processes
○ Risk for ineffective tissue perfusion related to aneurysm rupture as evidenced by
hemorrhage and lack of blood flow to tissues
○ Risk for injury related to pressure on the aneurysm
○ Anxiety related to the nature of the disorder

NURSING INTERVENTIONS
Acute interventions
It is seen in two ways:
○ Pre-operative
○ Post-operative

PRE-OPERATIVE
○ Nurse the patient in the supine position to relieve pain
○ Brief explanation of the disease process
○ Teaching the patient and family about the procedure that is to take place on the patient
○ Provide support for the patient and the family with careful assessment of all body systems
○ Assess the patient ready for the planned surgery.
○ Pre-surgical assessment include giving IV fluids, Sample collection, vital signs and
dressing the patient with theatre clothes

POST-OPERATIVE
In most cases such patients are nursed in ICU for close monitoring The nurse inserts the
following:
○ Urinary indwelling catheter ○ Endotracheal tube
○ Nasogastric tube
○ The nurse should monitor BP, administer IV fluids and blood components which are
important for adequate blood flow to the graft
○ The nurse should monitor urinary input and output which help in assessing the patient's
hydration and perfusion status
Health promotion
○ Teaching patient measures of health promotion with special attention to patients with
family history of aneurysm
Health promotion
○ The patient should encouraged to reduce cardiovascular risk factors such as BP control,
smoking cessation, increasing physical activity and maintaining normal body weight

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 AMBULATORY AND HOME CARE
○ Encourage the patient to express any concerns and assure the patient that you are available.
○ Assure the patient that normal activities of daily living will be resume soon
○ The patient should be instructed of increase gradually in activities such as fatigue, poor
appetite and regular habits should be expected
○ Heavy lifting should be avoided.
○ Any increased pain, drainage from
incision, increased fever of greater than 38°c should be reported to the hospital

COMPLICATIONS
○ Cardiac tamponade
○ Rupture
○ Hemorrhage
○ death
Expected outcomes
○ Adequate tissue perfusion
○ Normal body temperature
○ No sign of infection

BIBLIOGRAPHY
1. Lewis, Heitkemper, Dirksen (2007) Medical Surgical, Nursing; 7th edition, Mosby
Elsevier, USA
2. Priscilla Lemone and Karen Burk(2008) Medical Surgical Nursing, Fourth Edition,
Pearson Education Inc. New Jersey, USA