The nursing care for Abdominal aortic aneurysm patient with Endovascular aortic aneurysm repair (EVAR): Case study

Abstract

Patients with abdominal aortic aneurysm (AAA) are at high risk of death. After being diagnosed, these patients need urgent care to reduce complications and mortality.    

Objective: To compare between 2 abdominal aortic aneurysm patients with endovascular aortic aneurysm repair (EVAR), using the nursing process and the conceptual framework for assessing health status of FANCAS.

Method: This study compare between 2 abdominal aortic aneurysm patients with endovascular aortic aneurysm repair (EVAR) who were admitted in surgical intensive care unit, Chonburi Hospital between May to October 2021. The data was collected from inpatient medical record, observation, interview patients and their relatives.

Results: The case studies of two patients had the same factors: sex (male), age (older), smoking, including those with high blood pressure and hyperlipidemia. Diagnosis is through physical examination, ultrasound examination of the abdomen and computed tomography angiography (CTA) of the abdominal arteries. This two case were found similar symptoms, that is abdominal pain, pulpable and pulsatile abdominal mass, and the same nursing diagnosis were that: 1) Risk for abdominal aortic aneurysm rupture before surgery. 2) Water and electrolyte imbalance. 3) Risk for endovascular aortic aneurysm repair ruptured and leakage (endoleak) in post operative. 4) Ineffective airway clearance. 5) The patient is unwell due to pain. 6) Risk for imbalanced nutrition: less than body requirement 7) Risk for complications from surgery. 8) Impaired self-care related to daily activities. 9) Patients and their relatives were anxious related to critical ill. The difference of nursing diagnosis in case study 1 has a vascular infection and imbalance of water and electrolyte substances due to a lot of urine output after surgery, and case study 2 there is an imbalance of water and electrolyte substances since before surgery due to eating less food since before coming to the hospital.

Case study summary: A case study of elderly patients, high blood pressure and dyslipidemia which affects the condition of the disease and medical treatment. Before surgery, blood pressure and pain must be controlled to prevent the ruptured aneurysm, no complications, reduced disability and mortality.