Don Mariano Marcos Memorial State University

South La Union Campus

Institute of Community Health and Allied Medical Sciences
Agoo, La Union

Aneurysm- an outpouching, or bulge, that develops in the wall of an artery.1

- occur in the arteries, which are the blood vessels that carry blood away
from the heart.
- are much more common than venous aneurysms
- may be attributed to the significantly higher blood pressure that occurs
in arteries

* The main threat posed by an arterial aneurysm is that the blood vessel may eventually
rupture. . If this occurs, then tissues that are supplied with blood by the affected artery
will be starved of the nutrients and, critically, the oxygen that they need. Rupture usually
only occurs when an aneurysm has become very large. Therefore, it is important that
patients who possess an arterial aneurysm carefully manage their blood pressure, as high
blood pressure increases the risk of an arterial aneurysm growing, and may ultimately
lead to rupture.

Classification of Aneurysm:

1. Fusiform aneurysm- involves outpouching of both sides of the artery.

2. Saccular aneurysm- involves outpouching of only one side of the artery.
3. Dissecting aneurysm- involves separation or tear in the tunica intima and tunica
media.

Type of Aneurysm:

1. Aortic aneurysm- a general term for any swelling (dilatation or aneurysm) of

the aorta, usually representing an underlying weakness in the wall of the aorta at
that location. While the stretched vessel may occasionally cause discomfort, a
greater concern is the risk of rupture, which causes severe pain; massive internal
hemorrhage; and, without prompt treatment, results in a quick death.

- Aortic aneurysms are classified by where on the aorta they occur; aneurysms can appear
anywhere.

 Aortic root aneurysm, or aneurysm of sinus of Valsalva- appears on the

sinuses of Valsalva or aortic root.
 Thoracic aortic aneurysms- are found on the thoracic aorta; these are further
classified as ascending, aortic arch, or descending aneurysms depending on the
location on the thoracic aorta involved.
 Abdominal aortic aneurysm (AAA) - most common type of aneurisms that
often occur in older patients.
- characteristic manifestation of AAA is pulsatile mass over the
abdomen
- others are as follows:
a. low back pain
b. lower abdominal pain
c. flank pain
d. collapse

1
Arterial Aneurysm
Presented by: Jamie D. Manuel BSN IIIA
 e. shock

- General symptoms may include:

a. anxiety or feeling of stress;
b. nausea and vomiting;
c. clammy skin;
d. rapid heart rate.

2. circle of Willis (the base of the brain) aneurysm

- Most frequent site of occurrence is in the anterior cerebral artery
- Common symptoms:
a. severe pain,
b. loss of nervous sensation,
c. blurred vision,
d. vomiting,
e. strokes.

- the most common cause of aneurysm is HYPERTENSION.

- The most common complication of aneurysm is rupture, causing
massive internal hemorrhage, shock and death.

RISK FACTORS
 Age over 60 years
 Family history of AAA
 Tobacco use
 History of heart disease or peripheral arterial disease
 High blood pressure (hypertension)

COLLABORATIVE MANAGEMENT

- Medical Management
 antihypertensive drug

- Treatment
 surgery if aneurysm is greater that 4 cm
 Teflon/Dacron/gortex graft maybe used in surgical repair of aneurysm
 Aneurysms are treated by either endovascular techniques (angioplasty with stent)
or open surgery techniques. Open techniques include exclusion and excision.
Exclusion of an aneurysm means tightly tying suture thread around the artery both
proximally and distally to the aneurysm, to cut off blood flow through the
aneurysm. If the aneurysm is infected or mycotic, it may then be excised (cut out
and removed from the body). If uninfected, the aneurysm is often left in place.
After exclusion or excision, a bypass graft can be placed, to ensure blood supply
to the affected area. For some aneurysm repairs in the abdomen, where there is
adequate collateral blood supply, bypass grafts are not needed.

- Nursing Interventions
 maintain tissue perfusion
1. VS and hemodynamic measurements
2. Urine output, BUN, creatinine levels
2

2
Arterial Aneurysm
Presented by: Jamie D. Manuel BSN IIIA
 3. Bowel sounds, passage of flatus3
4. peripheral pulses(presence and quality
 promoting Fluid Volume
1. check dressing for excessive drainage
2. assess for abdominal pain or backpain(retroperitoneal hemorrhage)
3. Assess hgb and hct values

3
Arterial Aneurysm
Presented by: Jamie D. Manuel BSN IIIA