Aortic aneurysm: Nursing process (ADPIE)

David Carter is a 65-year-old male client who arrives at the Primary Care Clinic for his annual follow-up appointment.

He is a current smoker and has a history of hypertension and atherosclerosis.

He was diagnosed with 4.0 cm asymptomatic abdominal aortic aneurysm last year.

Mr. Carter brought in his blood pressure machine from home, and he tells the front desk staff he is feeling anxious about his appointment today.

The aorta is a large elastic artery that carries blood from the left ventricle of the heart, down through the thorax and abdomen.

The artery wall consists of three layers: the tunica intima, tunica media, and the tunica adventitia, which are composed of smooth muscle, elastic fibers and collagen which give the artery strength and elasticity.

If an area of weakness develops along the aorta, a dilation or bulge forms, called an aneurysm.

Aortic aneurysms are described according to their location, shape, size, and whether they involve all or part of the artery wall.

So, if the aneurysm forms within the abdominal cavity, it’s called an abdominal aortic aneurysm, or Triple-A.

Likewise, if the aneurysm is found within the thorax, or chest, it’s called a thoracic aortic aneurysm, or T double-A.

Finally, a thoracoabdominal aortic aneurysm, or T triple-A involves both the thoracic and abdominal aorta.

Aortic aneurysms come in two basic shapes.

A circular dilation that involves the entire circumference of the aorta is called a fusiform aneurysm.

In contrast, a saccular aneurysm is formed when there’s only a localized outpouching, like a bubble on the side of the aorta.

Both fusiform and saccular aneurysms are classified as true aneurysms because they involve all three layers of the aortic wall.