An aneurysm is a ballooning of an artery. The greatest risk for these clients is rupture and hemorrhage. Aneurysms can occur in any artery in the body and can be due to congenital malformations or arteriosclerosis or be secondary to hypertension. The following are several types of aneurysms:
- Fusiform—This aneurysm affects the entire circumference of the artery.
- Saccular—This aneurysm is an outpouching affecting only one portion of the artery.
- Dissecting—This aneurysm results in bleeding into the wall of the vessel.
Frequently, the client with an abdominal aortic aneurysm complains of feeling her heart beating in her abdomen or lower back pain. Any such complaint should be further evaluated. On auscultation of the abdomen, a bruit can be heard. Diagnosis can be made by ultrasound, arteriogram, or abdominal x-rays.
If the aneurysm is found to be 6 centimeters or more, surgery should be scheduled. During surgery the aorta is clamped above and below and a donor vessel is anastamosed in place. When the client returns from surgery, pulses distal to the site should be assessed and urinary output should be checked. Clients who are not candidates for surgery might elect to have stent placement to reinforce the weakened artery. These stents are threaded through an incision in the femoral artery, hold the artery open, and provide support for the weakened vessel. See Figure 13.5 for a diagram of an abdominal aortic aneurysm.
Figure 13.5 Abdominal aortic aneurysm.