DISORDERS OF THE AORTA AND ITS BRANCHES • Abdominal – occur often 4x more often

Aneurysm than thoracic aneurysm (AAA –

- localized, permanent, abnormal blood Abdominal Aorta Aneurysm)
vessel dilatation caused by localized
weakness and stretching in the middle
layer (Media) of wall of the artery.
(Intima – inner layer, Adventicia – outer
layer of artery)

PATHOPHYSIOLOGY

CLASSIFICATIONS
According to the arterial wall involved
• True aneurysm – one, two, or three
layers of the artery are involved
• Fusiform – spindle shaped expansion of
the entire circumference of involved
vessel

• Saccular – protrusion to one side of the

arterial wall
• Dissecting – hematoma that splits the
layer of the arterial wall • Cerebral – occur in the anterior cerebral
• False aneurysm – a pulsating artery in the Circle of Willis
hematoma, clot, and connective tissue
that are outside of the arterial wall ACCORDING TO ETIOLOGY
• Congenital – primary connective tissue
ACCORDING TO LOCATION disorder
• Aortic – occur in the aorta between • Acquired
renal arteries and iliac branches
• Atherosclerotic
• Thoracoabdominal – involve thoracic
• Mycotic – fungal or bacterial infections
and abdominal aorta
Abdominal Aortic Aneurysm - Renal Function studies
- Dilation, stretching or ballooning of the - Chest X-Ray
aorta
- When untreated -> Enlarge -> Rupture
-> Death (If you feel a pulsating mass in
the abdomen of the patient. DO NOT
PALPATE THE SITE. We might rupture it.
- CAUSE: Atherosclerosis – most common
o Congenital weakening of the
artery wall or trauma
o Trauma
o Disease
RISK FACTORS
1. Genetic Predisposition
2. Smoking
MEDICATION MANAGEMENT
3. HPN
- Closely monitor the size of aneurysm
- Drug Therapy: Antihypertensive agents
CLINICAL MANIFESTATIONS
– uncontrolled HPN increases the size of
- Signs of impending rupture: intense
aneurysm and increases the risk for
abdominal pain and back pain
Rupture
- Pulsating abdominal mass in the middle
and upper abdomen
- Rupture AAA: constant intense back
pain, decreased BP and Hct
- retroperitoneal rupture may result in
hematomas in the scrotum, perineum,
flank, or penis

LABORATORY AND DIAGNOSTIC TEST

- Abdominal Ultrasound

NURSING MANAGEMENT
- CT Scan or MRI
- Duplex Ultrasonography or CTA
- Watch out for signs and symptoms of
Rupture
- Watch out for vital signs and
hemorrhagic shock
- Post Endovascular Repair
- Supine for 6 Hours
- Elevate head of the bed (45 degrees)
after 2 hours
- Complete bed rest (CBR) with bedpan
 - VS q 15 minutes
- Doppler assessment until stable
- Assesses for: Bleeding, pulsation,
swelling, pain, and hematoma
formation
- Signs of embolization
- Signs of Post-Implantation Syndrome

POSSIBLE COMPLICATIONS OF SURGERY

1. Arterial occlusion
2. Hemorrhage
3. Infection
4. Ischemic bowel
5. Kidney injury
6. Impotence – due to prolonged period of
un-oxygenation in the male
reproductive tract

COMMON NURSING DIAGNOSIS FOR

PERIPHERAL VASCULAR DISORDERS
- Altered peripheral tissue perfusion
- Pain
- Risk for Impaired Skin Integrity
- High risk for infection
- Knowledge deficit
- Disturbed Body Image