Updated Care Plan for Abdominal Aortic Aneurysm

Category / Primary Body System:

Cardiovascular / Emergency Care

Problem:

Patient is at risk for complications related to an abdominal aortic aneurysm (AAA).

Goal:

The patient will have no signs of aneurysm rupture or leak for 90 days.

Plan/Approach:

1. Symptom Monitoring:

   • Step: Monitor closely for signs and symptoms of aneurysm bleeding or leakage. This includes a pulsating abdominal mass, abdominal or back pain, groin or flank pain, and signs of rupture such as intense pain in one or both flanks with radiation to the lower abdomen, groin, or genitalia, signs of shock, abdominal distention, pulsating abdominal mass, and ecchymosis in the flank or perianal area.
   • Rationale: Early detection of symptoms can prevent catastrophic outcomes by facilitating prompt medical intervention.
   • Actions: Perform regular abdominal assessments, document findings, and immediately report any abnormal signs to the MD.

2. Emergency Preparedness:

   • Step: Notify the MD immediately and prepare for emergency hospital transportation if signs of aneurysm rupture are detected.
   • Rationale: Timely medical intervention is critical in the event of an aneurysm rupture to save the patient’s life.
   • Actions: Ensure that emergency contact information is readily available and that the patient’s medical information is up-to-date. Prepare for rapid transportation to the hospital if necessary.

3. Diagnostic Testing:

   • Step: Conduct diagnostic testing as ordered and notify the MD, family, and resident of the results.
   • Rationale: Diagnostic tests help monitor the aneurysm’s status and guide treatment decisions.
   • Actions: Schedule and facilitate diagnostic tests such as ultrasounds or CT scans, and communicate the results promptly to the relevant parties.

4. Strain Prevention:

   • Step: Encourage the patient to avoid heavy straining with bowel movements.
   • Rationale: Reducing strain helps prevent an increase in intra-abdominal pressure, which can exacerbate the aneurysm.
   • Actions: Provide dietary recommendations to promote regular bowel movements, and consider stool softeners or laxatives as needed.

5. Cough Management:

   • Step: Intervene with any heavy coughing spells to avoid increased intra-abdominal pressure.
   • Rationale: Managing cough helps prevent sudden increases in abdominal pressure that could stress the aneurysm.
   • Actions: Administer antitussive medications if appropriate and encourage the patient to use splinting techniques when coughing.

6. Education:

   • Step: Provide teaching to the patient and family regarding the diagnosis, signs, and symptoms of aneurysm complications.
   • Rationale: Educating the patient and family empowers them to recognize early warning signs and seek timely medical help.
   • Actions: Use educational materials and one-on-one teaching sessions to explain the condition, potential complications, and necessary precautions.

7. Symptom Reporting:

   • Step: Encourage the patient to report any early symptoms to nursing staff and avoid waiting for full-blown symptoms.
   • Rationale: Prompt reporting of symptoms allows for early intervention, potentially preventing severe complications.
   • Actions: Reinforce the importance of reporting symptoms such as new or worsening pain immediately to the nursing staff.

8. Laboratory Monitoring:

   • Step: Monitor labs as ordered and report results to the MD.
   • Rationale: Regular lab monitoring helps track the patient’s overall health and detect any issues that could affect the aneurysm.
   • Actions: Collect and analyze lab samples as ordered, document results, and communicate any concerns to the MD promptly.