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Title:

Disorders of the Aorta

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Increased age & smoking ( 70 yoa) 90% develop renal arteries ... Bruit over mass found on exam. Pain is constant or intermittent. Emboli in lower extremities ... – PowerPoint PPT presentation

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Title: Disorders of the Aorta


1
Disorders of the Aorta
  • Susie Forehand RN, MSN
  • Leslie S. Lorette, RN, MSN

2
Aortic Aneurysms
  • Thoracic
  • Account for 10
  • Weakening of wall due to HTN arteriosclerosis
  • Trauma
  • Coarctation
  • Tertiary syphilis
  • Fungal infections
  • Marfans syndrome
  • Asymptomatic
  • Symptoms with location
  • Ascending arch
  • Dysphagia
  • Dyspnea
  • Hoarseness
  • Confusion
  • Dizziness
  • Rupture ? Death

3
  • Abdominal
  • HTN arteriosclerosis
  • Increased age smoking (gt 70 yoa)
  • 90 develop ? renal arteries
  • Asymptomatic
  • Pulsating mass in mid and upper abdomen
  • Bruit over mass found on exam
  • Pain is constant or intermittent
  • Emboli in lower extremities
  • Rupture

4
Diagnostics
  • Chest X-ray
  • Abdominal ultrasonography
  • Transesophageal echocardiography (TEE)
  • Contrast-enhanced CT or MRI
  • Angiography

5
Treatment
  • Asymptomatic and low risk for rupture
  • Beta-blockers
  • Clients with dissection
  • Control heart rate and blood pressure
  • beta-blockers and sodium nitroprusside (Nipride)
  • Constant hemodynamic monitoring
  • prevent rupture
  • stabilize client before aneurysm is repaired
    surgically
  • Post surgical
  • anticoagulant therapy
  • Heparin
  • Oral anticoagulants or low-dose aspirin

6
Surgical Intervention
  • Indications
  • Symptomatic or rapidly expanding aneurysms
  • Thoracic gt6 cm diameter
  • Abdominal gt5 cm diameter
  • Types of procedures
  • Excised and replaced with synthetic fabric graft
  • Endovascular stent grafts

7
Post-op Management
  • Monitor for Graft leakage
  • ? ecchymosis
  • ? abdominal girth
  • Weak or absent distal pulses
  • ? HH
  • ? abdominal, pelvic, back or groin pain
  • ? urine output
  • ? CVP or PWCP

8
Post-op Management
  • Fluid replacement
  • Maintain arterial perfusion
  • Monitor for extremity embolism
  • 6 Ps
  • Monitor for bowel ischemia
  • Maintain renal function
  • Monitor for spinal cord ischemia

9
Home Care
  • Not had repair of aneurysm
  • Manifestations of increasing size, dissection, or
    rupture
  • Control of hypertension
  • Smoking cessation
  • Who have had surgical repair
  • Wound care
  • Medications
  • anticoagulation
  • antihypertensive
  • Nutritional needs
  • ? PO fluids fiber
  • Adequate rest
  • Exercise
  • Reportable symptoms
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