Podcast
Questions and Answers
What is the most common cause of abdominal aortic aneurysm (AAA)?
What is the most common cause of abdominal aortic aneurysm (AAA)?
- Hypertension
- Atherosclerosis (correct)
- Smoking
- Obesity
Which of the following are classified as types of true aneurysms? (Select all that apply)
Which of the following are classified as types of true aneurysms? (Select all that apply)
- Saccular (correct)
- False
- Dissecting
- Fusiform (correct)
- Pseudoaneurysm
Which diagnostic test is most commonly used initially to assess AAA?
Which diagnostic test is most commonly used initially to assess AAA?
- Angiogram
- MRI
- CT scan
- Ultrasound (correct)
At what size is an abdominal aortic aneurysm typically considered for surgical repair?
At what size is an abdominal aortic aneurysm typically considered for surgical repair?
Which of the following are risk factors for developing AAA? (Select all that apply)
Which of the following are risk factors for developing AAA? (Select all that apply)
A patient with AAA presents with sudden severe abdominal pain. What should the nurse suspect?
A patient with AAA presents with sudden severe abdominal pain. What should the nurse suspect?
Which lab values should be monitored post AAA repair for renal perfusion?
Which lab values should be monitored post AAA repair for renal perfusion?
Which of the following are components of post-operative assessment following an endovascular aortic repair? (Select all that apply)
Which of the following are components of post-operative assessment following an endovascular aortic repair? (Select all that apply)
Which of the following describes a false aneurysm?
Which of the following describes a false aneurysm?
Which intervention helps prevent graft thrombosis post AAA surgery?
Which intervention helps prevent graft thrombosis post AAA surgery?
Why is it important to monitor urine output following open AAA repair?
Why is it important to monitor urine output following open AAA repair?
A nurse is educating a patient with a small AAA under surveillance. Which points should be included in the teaching? (Select all that apply)
A nurse is educating a patient with a small AAA under surveillance. Which points should be included in the teaching? (Select all that apply)
Which finding would suggest ineffective lower extremity perfusion post-op AAA?
Which finding would suggest ineffective lower extremity perfusion post-op AAA?
Why is abdominal distention monitored after open AAA repair?
Why is abdominal distention monitored after open AAA repair?
The nurse is assessing for signs of post-op bleeding following AAA surgery. What should be monitored? (Select all that apply)
The nurse is assessing for signs of post-op bleeding following AAA surgery. What should be monitored? (Select all that apply)
Which of the following statements best explains why BP must be tightly controlled post-op AAA?
Which of the following statements best explains why BP must be tightly controlled post-op AAA?
What is the purpose of maintaining an NG tube post-op AAA repair until flatus is passed?
What is the purpose of maintaining an NG tube post-op AAA repair until flatus is passed?
Which interventions help manage the risk for fluid volume deficit after AAA surgery? (Select all that apply)
Which interventions help manage the risk for fluid volume deficit after AAA surgery? (Select all that apply)
Which rationale explains the risk for infection after AAA repair?
Which rationale explains the risk for infection after AAA repair?
What nursing diagnosis is most appropriate for a post-op AAA patient with a BP of 88/56 mmHg and decreased urine output?
What nursing diagnosis is most appropriate for a post-op AAA patient with a BP of 88/56 mmHg and decreased urine output?
A nurse is caring for a patient with a 4.8 cm AAA under surveillance. The patient reports they continue to smoke despite being advised to stop. What is the most appropriate nursing action?
A nurse is caring for a patient with a 4.8 cm AAA under surveillance. The patient reports they continue to smoke despite being advised to stop. What is the most appropriate nursing action?
A nurse is caring for a patient post-endovascular AAA repair. Which of the following actions are appropriate? (Select all that apply)
A nurse is caring for a patient post-endovascular AAA repair. Which of the following actions are appropriate? (Select all that apply)
A patient post-open AAA repair has no bowel sounds and an abdominal girth increase. What is the priority action?
A patient post-open AAA repair has no bowel sounds and an abdominal girth increase. What is the priority action?
While assessing a patient's post-op vitals, the nurse notes a BP of 178/92 mmHg and increasing abdominal pain. What is the priority action?
While assessing a patient's post-op vitals, the nurse notes a BP of 178/92 mmHg and increasing abdominal pain. What is the priority action?
A nurse is preparing discharge education for a patient post-AAA repair. What should be included? (Select all that apply)
A nurse is preparing discharge education for a patient post-AAA repair. What should be included? (Select all that apply)
Which patient behavior indicates a need for further teaching after AAA repair?
Which patient behavior indicates a need for further teaching after AAA repair?
Which signs would prompt the nurse to suspect graft thrombosis in a post-op AAA patient? (Select all that apply)
Which signs would prompt the nurse to suspect graft thrombosis in a post-op AAA patient? (Select all that apply)
A nurse notes a patient's urine output has decreased to 10 mL/hr, and creatinine is elevated post-op. What action should the nurse take first?
A nurse notes a patient's urine output has decreased to 10 mL/hr, and creatinine is elevated post-op. What action should the nurse take first?
Which order should the nurse question in a patient with newly diagnosed 5.2 cm AAA?
Which order should the nurse question in a patient with newly diagnosed 5.2 cm AAA?
Which findings would indicate adequate tissue perfusion in a patient post-AAA surgery? (Select all that apply)
Which findings would indicate adequate tissue perfusion in a patient post-AAA surgery? (Select all that apply)
A nurse is evaluating the effectiveness of pain management in a post-op AAA patient. What finding supports adequate pain control?
A nurse is evaluating the effectiveness of pain management in a post-op AAA patient. What finding supports adequate pain control?
The patient had open AAA repair. Which of the following would be part of the post-op care plan? (Select all that apply)
The patient had open AAA repair. Which of the following would be part of the post-op care plan? (Select all that apply)
Which statement by a patient under AAA surveillance indicates understanding?
Which statement by a patient under AAA surveillance indicates understanding?
A nurse is reviewing the chart of a post-AAA repair patient. Which documentation would require immediate follow-up? (Select all that apply)
A nurse is reviewing the chart of a post-AAA repair patient. Which documentation would require immediate follow-up? (Select all that apply)
Which is the best indicator of effective fluid volume status after AAA repair?
Which is the best indicator of effective fluid volume status after AAA repair?
A post-op AAA patient presents with a BP of 95/60 mmHg, cool extremities, and diminished pedal pulses. Which complication is most likely occurring?
A post-op AAA patient presents with a BP of 95/60 mmHg, cool extremities, and diminished pedal pulses. Which complication is most likely occurring?
The nurse is analyzing post-op data for a patient who had AAA repair. Which findings suggest effective renal perfusion? (Select all that apply)
The nurse is analyzing post-op data for a patient who had AAA repair. Which findings suggest effective renal perfusion? (Select all that apply)
A patient with known AAA suddenly develops confusion and a BP of 82/58 mmHg. What should the nurse suspect first?
A patient with known AAA suddenly develops confusion and a BP of 82/58 mmHg. What should the nurse suspect first?
During assessment of a patient recovering from AAA open repair, the nurse notes: HR 112 bpm, BP 86/50 mmHg, distended abdomen, and decreased bowel sounds. Which are likely contributing factors? (Select all that apply)
During assessment of a patient recovering from AAA open repair, the nurse notes: HR 112 bpm, BP 86/50 mmHg, distended abdomen, and decreased bowel sounds. Which are likely contributing factors? (Select all that apply)
A nurse is reviewing a patient's labs post-AAA repair. Which trend is most concerning and warrants further investigation?
A nurse is reviewing a patient's labs post-AAA repair. Which trend is most concerning and warrants further investigation?
A nurse evaluates the care plan for a patient with a newly diagnosed small AAA. Which interventions reflect a preventative strategy to delay aneurysm progression? (Select all that apply)
A nurse evaluates the care plan for a patient with a newly diagnosed small AAA. Which interventions reflect a preventative strategy to delay aneurysm progression? (Select all that apply)
Which patient is at greatest risk for developing an AAA based on data analysis?
Which patient is at greatest risk for developing an AAA based on data analysis?
Which changes would require a nurse to re-evaluate a patient's recovery status after AAA repair? (Select all that apply)
Which changes would require a nurse to re-evaluate a patient's recovery status after AAA repair? (Select all that apply)
The nurse is caring for a patient post-endovascular AAA repair. Which assessment finding should be reported immediately?
The nurse is caring for a patient post-endovascular AAA repair. Which assessment finding should be reported immediately?
Which findings indicate potential post-op infection after AAA surgery? (Select all that apply)
Which findings indicate potential post-op infection after AAA surgery? (Select all that apply)
Flashcards
Common AAA cause?
Common AAA cause?
The most common cause of AAA is atherosclerosis, which weakens arterial walls, promoting dilation.
True aneurysm types?
True aneurysm types?
Fusiform and saccular aneurysms are types of true aneurysms. Dissecting and false aneurysms are different entities.
AAA initial assessment?
AAA initial assessment?
Ultrasound is non-invasive and commonly the first diagnostic tool for AAA.
AAA surgical repair size?
AAA surgical repair size?
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AAA risk factors?
AAA risk factors?
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AAA rupture symptoms?
AAA rupture symptoms?
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Post-AAA repair labs?
Post-AAA repair labs?
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Post-AAA repair checks?
Post-AAA repair checks?
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False aneurysm?
False aneurysm?
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Post-AAA fluids?
Post-AAA fluids?
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AAA urine output?
AAA urine output?
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AAA lifestyle changes?
AAA lifestyle changes?
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AAA absent pulses?
AAA absent pulses?
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AAA distended abdomen?
AAA distended abdomen?
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AAA bleeding signs?
AAA bleeding signs?
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AAA blood pressure?
AAA blood pressure?
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AAA NG tube?
AAA NG tube?
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AAA fluid deficit?
AAA fluid deficit?
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Smoking & AAA Growth
Smoking & AAA Growth
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Study Notes
Abdominal Aortic Aneurysm (AAA)
- Atherosclerosis is the most common cause
- It weakens arterial walls, promoting dilation
True Aneurysms
- Fusiform and saccular aneurysms are types
- Dissecting and false (pseudoaneurysms) are different entities
AAA Assessment
- Ultrasound is non-invasive
- Ultrasound is commonly used as the first diagnostic tool for AAA
Surgical Repair
- Surgery for AAA is usually recommended when the AAA is greater than 4–5 cm
- Surgery is usually recommended when symptomatic
AAA Risk Factors
- Risk factors include age > 65
- Risk factors include male gender
- Risk factors include family history
- Risk factors include smoking
AAA Symptoms
- Sudden severe abdominal pain is a symptom
- Dissection or rupture, is a surgical emergency
Post-AAA Repair Monitoring
- BUN and creatinine should be monitored post-AAA repair
- BUN and creatinine reflect renal function, which may be compromised due to impaired perfusion post-op
Post-Endovascular Aortic Repair Assessment
- Groin site checked for bleeding
- Distal pulses and BP assess perfusion and hemodynamic status
False Aneurysm
- False aneurysms include bleeding contained by surrounding tissue
- Blood contained by tissues rather than the vessel wall
Post AAA Surgery
- IV fluids help prevent graft thrombosis
- Adequate hydration helps prevent thrombosis and supports perfusion to grafted areas
Post-Open AAA Repair
- Monitoring urine output (goal: ≥30 mL/hr) provides early indication of kidney perfusion and function
Small AAA Under Surveillance
- Lifestyle modifications including smoking cessation slow aneurysm progression
- Lifestyle modifications including weight management slow aneurysm progression
- Lifestyle modifications including BP control slow aneurysm progression
Post-op AAA Complications
- Absent dorsalis pedis pulses may indicate graft occlusion or thrombosis
- Graft occlusion or thrombosis requires immediate evaluation
Abdominal Distention
- Monitored after open AAA repair
- May indicate paralytic ileus or ischemia due to aortic clamping affecting bowel perfusion.
Post-op Bleeding
- Monitor BP trends
- Monitor Hgb/Hct levels
- Monitor abdominal/back pain
- Monitor surgical dressing for drainage
Post-op BP Control
- High BP increases risk of graft leakage or rupture
- Low BP impairs organ perfusion
Post-op NG Tube
- An NG tube is maintained post-op AAA repair until flatus is passed
- The bowel is manipulated during surgery and may become temporarily paralyzed
- NG decompression helps
Fluid Volume Deficit Management
- Administer IV fluids as ordered
- Monitor hemoglobin and hematocrit
- Monitor urine output
- Diuretics are not routine post-op
Infection Risk Post-AAA Repair
- The surgical site introduces infection risk
- Infection risk is especially relevant with groin incisions or open repairs
Post-op AAA Patient
- Hypotension and low urine output suggest compromised renal perfusion
- Compromised renal perfusion requires immediate attention
Patient with 4.8 cm AAA
- Smoking contributes to vascular damage and progression of AAA
- Reinforcing patient education promotes adherence
Post-Endovascular AAA Repair
- Assess for bleeding at the groin insertion site
- Monitor lower extremity pulses
- Maintain BP within a specific range
- Ambulation and dressing removal need provider clearance
Post-Open AAA Repair
- No bowel sounds and abdominal girth increase indicates bowel ischemia or paralytic ileus
- Requires provider intervention
Elevated BP
- Elevated BP can cause graft rupture
- Requires urgent evaluation
Post-AAA Repair Discharge
- Monitor for signs of infection
- Keep the incision dry
- Avoid lifting heavy objects
- Report chest or back pain immediately
- Complications focus on preventing strain on the graft and identifying signs
Need for Further Teaching
- Lifting heavy objects post-op can risk graft integrity
Graft Thrombosis Signs
- Cool, pale legs
- Absent femoral pulse
- Delayed capillary refill
- These are signs of impaired distal perfusion and possible thrombosis
Acute Kidney Injury Signs
- Decreased urine output to 10 mL/hr
- Elevated Creatinine
- Immediate provider notification is critical
Poor Perfusion Signs
- Cap refill > 4 seconds
- Pale, cold extremities
- Urine output 25 mL/hr
- Urine output 25 mL/hr is an early sign of complications
Fluid Volume Status
- Balanced I&O offers a measurable indicator of fluid volume
- High BP and temperature can be influenced by other variables
Post-op Complications
- Low BP, cool extremities, and poor distal pulses suggest reduced circulating volume affecting organ perfusion
Effective Renal Perfusion Signs
- Urine output 35 mL/hr are signs of renal perfusion
- Normal BUN suggests renal function is intact
AAA Rupture Recognition
- Hypotension and acute mental status change may signal poor cerebral perfusion due to rupture and hemorrhage
AAA Open Repair Assessment
- Paralytic ileus may contribute
- Hemorrhage may contribute
- Abdominal compartment syndrome may contribute
- Symptoms are consistent with internal bleeding or abdominal distention, compressing organs and impeding perfusion
Sharp Rise in Creatinine
- Indicates impaired renal perfusion or acute kidney injury
Preventative Strategy to Delay Aneurysm Progression
- Monitor size via regular imaging
- Administer antihypertensives
- Encourage smoking cessation
- Provide dietary counseling
- Anticoagulation isn't standard unless other conditions exist
AAA Risk Factors
- Age >65 are key risk factors
- Male gender are key risk factors
- Smoking and hypertension are key risk factors
Recovery Status Re-Evaluation
- Absent bowel sounds
- Sharp back pain
- Pale, cold feet
- Signs of possible complications: ileus, rupture, or thrombosis
Post-Endovascular AAA Repair
- Report immediately if diminished right pedal pulse compared to left
- Pulse asymmetry suggests impaired perfusion or graft complications
- Elevated WBC suggests infection
- Elevated Temperature signs suggest infection
- Purulent wound drainage is indicative of infection
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