definition, causes, types, clinical manifestation,management, diagnosis

2. INTRODUCTION:-
The term ANEURYSM is derived from the Greek ward
ANEURYSMA means “a widening”. When blood passes
through the weakened blood vessels, the blood
pressure causes a small area to bulge outwards like a
balloon.

3. According to American heart association “ an
Aneurysm occurs when part of an artery wall
weakness, allowing it to widen abnormally or balloon
out.
“An Aneurysm is an abnormal bulge or
ballooning in the wall of an artery” . (Javed Ansari)

4. 1. According to Size:-
Fusiform Aneurysm:- It is a diffused dilation that
involves the entire circumference of the arterial segment
i.e. whole artery.
Secular Aneurysm:- Its a distension of a vessels
projecting from one side. It is a localised out pouching of
arterial wall.
Dissecting Aneurysm:- An
aneurysm in which the wall
of an artery rips (dissects)
longitudinally. This occurs
because bleeding into the
weakened wall splits the wall.
Dissecting aneurysms tend to affect the thoracic aorta.

5. 2. According to cause:-
True Aneurysm:- It is the result of the slow
weakening of the arterial wall caused by long term
disease such as hypertension, atherosclerosis etc.
False Aneurysm:- Pseudo aneurysm is caused by
traumatic break in the arterial wall.

6. There are three type of aneurysm, those are:-
Aortic aneurysm
Cerebral aneurysm
Peripheral Aneurysm
Aortic Aneurysm:- It is the aneurysm which aneurysm
occur in aorta. There are two type of aneurysm, those
are:-
Thoracic aortic aneurysm:- It is a type of aneurysm
which develop in the part of aorta running through the
thorax is called thoracic aortic aneurysm.

7. Abdominal aortic aneurysm:- It occur in the in the part
of the aorta running through abdomen is called
abdominal aortic aneurysm.
Cerebral Aneurysm:- An aneurysm that occur in an
artery in the brain are called aneurysm. They are often
known as berry aneurysm because they are often the
size of a small berry.
Peripheral Aneurysm:- Here the aneurysm occur other
then aorta & brain. Common location for development of
peripheral aneurysm are popliteal artery, femoral artery,
carotid artery.

8. A congenital abnormalities
A defective gene
Atherosclerosis
Severe & persistent high BP.
Smoking.
Obesity
Family history of aneurysm
Trauma such as a blow to the chest in a car accident
Deep wound, injuries or infection of blood vessels
Certain disease that can weaken the wall of the aorta
such as Marfan syndrome, its an inherited disease which
tissue develop normally .

9. Thoracic Aortic Aneurysm:- Pain in jaw, neck, chest pain,
upper beck or pain in left shoulder or between shoulder
blades, shortness of breath, coughing, hoarseness.
Abdominal aortic aneurysm:- Deep penetrating pain in the
beck of the or side of the abdomen, coldness, numbness or
tingling in the feet due to blocked blood flow in the
legs,nausea, vomiting, clammy sweaty skin, light
headedness, rapid heart rate when stand up, shock
Cerebral artery aneurysm:- A droopy eyelid, double vision,
Pain in eye, A dilated pupil, numbness or weakness on the
side of the face.
Peripheral aneurysm:- A pulsating lump that can be felt in
the neck, arm or leg.
Leg or arm pain or cramping with exercise, painful sore on
toes or finger, gangrene in limbs,

10. History collection:- Family history of cardiovascular
disease, chronic hypertension, DM, symptoms etc.
Physical examination:- Vital sign, Pulsating mass
etc.
Chest X-ray
Ultrasound
Echocardiography
CT Scan.
MRI
Angiography
Aortagram

11. Goal:- To prevent the aneurysm from growing & damage
other structure.
Surgical Intervention:-
Open Repair:- Here aneurysm is removed & the section
of Aorta is replaced with artificial graft which are made
up of materials such as Dacron or Teflon.
Endovascular Repair:- Here the aneurysm is not removed
but a graft is inserted in to the aorta to strengthen it

13. Nursing Diagnosis:-
Ineffective tissue perfusion related to aneurysm
Risk of infection related to surgery
Pain related to procedure of aneurysm.
Knowledge deficit related to aneurysm & its
treatment.

14. Ineffective tissue perfusion of vital organ as evidenced
by hypertension or pulse oxymetry value
Goal:- To maintain tissue perfusion.
Intervention:-
Assess for sign & symptoms of bleeding: Hypotension,
tachycardia, Tachypnea, diaphoresis, Hypovolemia
shock.
Monitor laboratory value & urine output.
Perform neurovascular check to distal extremity.
Maintain IV infusion to administer medication to
control BP & provide fluid.

15. Risk for infection related to surgery as evidenced by
patient not maintaining personal hygiene.
Goal:- To reduce infection
Intervention:-
Monitor vital signs frequently & check WBC count
Monitor incision site for sign of infection
Limit visitors
Administer antibiotic drugs as prescribed to prevent
infection
Encourage adequate balanced diet.

16. Pain related to surgery as evidenced by increased pain
score
Goal:- To reduce pain.
Intervention:-
Keep the head of the bed elevated not more then 45
degree for first 3 days postoperatively to prevent
pressure on incision site.
Encourage the patient to maintain an exercise
schedule postoperatively.
Administer nasogastric decompression for ileus
following surgery until bowel sound return.
Administer pain medication.