VASCULAR DISORDER CASE STUDY

GROUP 5 (Shenice Graham , Marcus Garcia, Makila Kent , Naomi Emmanuel, Natalia Khan,
Monique Lewis, Vernice Isaac,Salisha Rampersad)

Age: 73 Sex: Male

Dx: Abdominal Aortic Aneurysm (AAA)

Allergies: nil known

Hx: Abdominal Aortic Aneurysm (AAA), Angina (occasionally) x 3 years

1. Mr. Maraj’s risk for an Abdominal Aortic Aneurysm (AAA) are: smoking 1 pack of cigarettes
per day for 52 years, his gender, age and a prior history of known AAA.

2. The etiologies of AAA are: Atherosclerosis, infectious aortitis, trauma, blood vessel & genetic
diseases.

3. Signs and Symptoms that make the nurse suspect that Mr. Maraj’s AAA has ruptured are as
follows: rapid heart rate of 114 bpm, low blood pressure of 88/68 mmHg, extremities are cool
and clammy suggesting shock.

4. In the case of 73 year old Mr. Maraj, the first priority should be to control the abdominal
aortic aneurysm as there is a possibility that it can rupture and cause many complications like
internal bleeding which can cause a person to rapidly go into shock and can be fatal.

5. The nurse’s role in assisting the family in this critical situation is as follows:

● Further explain to family the patients’ condition prior to what the doctor said.
● Council family members by advising them to attend consultations with the doctors and
ask questions about the condition for further knowledge.
● Update family members upon their concerns on the patients’ condition
● Be an advocate for the family members about various treatments for the patient.
 ● Encourage the family’s participation in decision making towards the patient health care
such as including the use of advance directives for which the patient's preference is

identified.

6.Steps that can be taken to prevent the rupture of a AAA include:

● Lowering Blood Pressure.

● Cessation of tobacco.
● Optimizing lipid profile.
● Yearly surveillance of the aneurysm size with the uses of CT’s, ultrasounds and MRI’s.
● The use of antibiotics and beta adrenergic blocking drugs may decrease the growth.
● Surgery is also used as the most efficient treatment for AAA by repairing the aneurysm
before it ruptures.

7.What discharge teaching should be included for this patient after the AAA repair?

a. Mr.Maraj will feel more tired than usual for several weeks, he will be advised to do light
to moderate exercises/activities because he will need a lot of rest as well as two (2) to
three (3) months to recover fully.
b. Do not lift any heavy objects because sutures can burst and cause bleeding and more
complications.
c. Change dressing over wound daily or when it becomes soiled until your health care
provider tells you that you don’t need it to be covered anymore.
d. Do not soak in bathtub or go swimming until you are told to do so by your health care
provider.
e. Surgery does not cure underlying problem with your blood vessels, which means other
blood vessels can be affected in the future. So, lifestyle changes and medical
management are important.

• Eat a heart healthy diet.

• Get regular exercise.

• Stop smoking.

• Take prescribed medication on time and correctly.

f. Press a pillow over your incision when you cough or sneeze to ease discomfort and
protect your incision.
g. Alert Physician if you have pain in the abdomen or back that doesn’t go away or is very
severe. Your legs are swelling, you have chest pain or SOB that does not go away, you
experience dizziness, fainting or feel tired. If you cough up blood, if you have a fever,
you have blood in your stool or develop blood diarrhea, the edges of your incision are
pulling apart. if you have green or yellow drainage and If your bandage in soaked with
blood or clear fluid.

8.Based on the assessment data presented, the priority nursing diagnoses are:

● Chronic pain related to the expansion/f rupture of the abdominal aortic aneurysm as
evidenced by the patient’s verbalization of severe back pain and occasional bouts of
angina for the past three years.

● Ineffective peripheral tissue perfusion related to the abdominal aortic aneurysm reducing
blood flow to the extremities as evidenced by the patient having cool and clammy
extremities.

● Ineffective health maintenance related to smoking as evidenced by patient’s verbalization

that he smoked a pack of cigarettes per day for 52 years.

● Risk for Impaired Skin Integrity related to impaired peripheral blood flow to the
extremities.