Question

Describe the clinical manifestations of dissecting aortic aneurysm. The treatment is an immediate surgical repair of the tear. Describe the nurse’s role in post-operative care. Be sure to state your highest-priority nursing problems. include references

Answer 1

Dissecting Aortic Aneurysm :

When the inner layers of the wall of the aorta gets separated from the middle layer of the aortic wall and pushes the blood through the tear, creates a false channel in the wall of the aorta.It causes further separation and leads to Dissecting aortic aneurysm.

Clinical Manifestations :

* Chest Pain and Pain between the shoulder Blades:

The dissection interrupts the blood flow to the coronary arteries and results myocardial ischemia . This gives the sharp pain in the chest and between shoulder blades.

* Abdominal Pain and Loss of Appetite

When the dissection descends and extends to the false lumen would block the mesentric arteries which supply blood to the intestines. It leads to excruiting abdominal pain.Moreover it will get away the feeling of hunger.

* Shortness of Breath

Shortness of breath happens when the dissection expands and causes blood to leak backward from the heart to the lungs.

* As the false lumen created by the dissection of aorta allows only the small amount of blood to the rest of the body cause dizziness, weak and thready pulse, profuse sweating, pale skin.

Nurses Role in Post-Operative Care:

* Fluid Resuscitation :

The nurse should administer fluids to replace the amount of blood loss for first 12 hours in the operating room. Because extensive blood loss may lead to hypovolemic shock.

*Monitoring Hemodynamic Stability:

The nurse is advised to monitor the surgical site for bleeding, strict documentation of Intake and output, checking peripheral pulses for the first 24 hours in the intensive Care Unit. Because, if the patient is not monitored closely he might collapsed at any time.

* Investigations:

  The nurse should send the patient to post-operative ECG and Chest X-ray as it may reveal any major changes. It would help the nurse to be proactive.

* Antibiotics :

  The nurse should get prescription from the physician and adjuster antibiotics the patient after surgery to prevent infections. Not admitting antibiotics after surgery may prolong the recovery time of the patient.