Treatments for Aneurysm
Treatments for Aneurysm
The list of treatments mentioned in various sources
for Aneurysm
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
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Abdominal Masses:
Treatment
(In a Page: Signs and Symptoms)
-
Immediate attention to life-threatening causes (e.g., ruptured abdominal aortic aneurysm)
-
Most cases of abdominal masses are treatable once the etiology is identified
-
Many malignant and benign masses (e.g., fibroids, hernia) require surgical intervention
-
Infectious causes require antibiotics and may require operative intervention (e.g., abscess drainage)
-
Constipation is typically treated with laxatives, enemas, and increased dietary fiber and fluids; manual disimpaction is reserved for fecal impaction; discontinue offending medications (e.g., narcotics)
-
Hirschsprung's disease may require operative treatment
-
Ogilvie's syndrome responds to decompression by rectal tube or IV neostigmine
-
Organomegaly typically resolves once the underlying process is treated (e.g., mononucleosis resulting in splenomegaly)
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Abdominal Masses:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Depends on specific etiology
-
Respiratory and hemodynamic stability of the patient must be secured before any evaluation or treatment
-
Prompt involvement of a pediatric surgeon, neurosurgeon, oncologist, urologist/urologic surgeon, gynecologist, or gastroenterologist will help streamline the approach
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Abdominal mass:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If the patient has a pulsating midabdominal mass and severe abdominal or back pain, suspect an aortic aneurysm. Quickly take his vital signs. Because the patient may require emergency surgery, withhold food or fluids until he’s examined. Prepare to administer oxygen and to start an I.V. infusion for fluid and blood replacement. Obtain routine preoperative tests, and prepare the patient for angiography. Frequently monitor blood pressure, pulse, respirations, and urine output.
Be alert for signs of shock, such as tachycardia, hypotension, and cool, clammy skin, which may indicate significant blood loss.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Femoral and popliteal aneurysms:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Femoral and popliteal aneurysms require surgical bypass and reconstruction of the artery, usually with an autogenous saphenous vein graft replacement. Arterial occlusion that causes severe ischemia and gangrene may require leg amputation.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Ventricular aneurysm:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Antiarrhythmics, anticoagulants, sodium nitroprusside, embolectomy, cardioversion, oxygen, cardiac glycosides, furosemide, supportive care (morphine, intubation, mechanical ventilation)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Dissecting abdominal aortic aneurysm:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Surgery, fluid replacement, pneumatic antishock garment
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Abdominal aneurysm:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Usually, abdominal aneurysm requires resection of the aneurysm and replacement of the damaged aortic section with a Dacron graft. (See Abdominal aneurysms: Before and after surgery. Also see Endovascular grafting for repair of an abdominal aortic aneurysm, page 1140.) If the aneurysm is small and asymptomatic, surgery may be delayed and the aneurysm may be followed and allowed to expand to a certain size because of possible surgical complications; however, small aneurysms may also rupture. Because of this risk, surgical repair or replacement is recommended for symptomatic patients or for patients with aneurysms greater than 5 cm in diameter.
Stenting is also a treatment option. It can be performed without an abdominal incision by introducing the catheters through arteries in the groin. However, not all patients with abdominal aortic aneurysms are candidates for this treatment.
Regular physical examination and ultrasound checks are necessary to detect enlargement, which may forewarn rupture. Large aneurysms or those that produce symptoms pose a significant risk of rupture and necessitate immediate repair. In patients with poor distal runoff, external grafting may be done.
Risk factor modification is fundamental in the medical management of abdominal aneurysm, including control of hypocholesterolemia and hypertension. Beta-adrenergic blockers are commonly prescribed to reduce the risk of aneurysm expansion and rupture.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cerebral aneurysm:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Surgical repair, bed rest, codeine, antihypertensives, calcium channel blockers, corticosteroids, phenytoin, phenobarbital, fibrinolytic inhibitor
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Thoracic aortic aneurysm:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Antihypertensives, negative inotropic agents, airway maintenance, opioids for pain, I.V. fluids, blood transfusions, surgery
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Abdominal mass:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient has a pulsating midabdominal mass and severe abdominal or back pain, suspect an aortic aneurysm. Quickly take his vital signs. Because the patient may require emergency surgery, withhold food or fluids until the patient is examined. Prepare to administer oxygen and to start an I.V. infusion for fluid and blood replacement. Obtain routine preoperative tests, and prepare the patient for angiography. Frequently monitor blood pressure, pulse rate, respirations, and urine output.
Be alert for signs of shock, such as tachycardia, hypotension, and cool, clammy skin, which may indicate significant blood loss.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Aneurysms, femoral and popliteal:
Treatment
(Handbook of Diseases)
Femoral and popliteal aneurysms require surgical bypass and reconstruction of the artery, usually with an autogenous saphenous vein graft replacement. Arterial occlusion that causes severe ischemia and gangrene may require leg amputation.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
aneurysm,ventricular:
Treatment
(Handbook of Diseases)
Depending on the size of the aneurysm and the complications, treatment may require only routine medical examination to follow the patient’s condition or aggressive measures for intractable ventricular arrhythmias, heart failure, and emboli.
Emergency treatment of ventricular arrhythmias involves an I.V. antiarrhythmic or cardioversion. Preventive treatment continues with an oral antiarrhythmic, such as procainamide, quinidine, or amiodarone.
Emergency treatment for heart failure with pulmonary edema includes oxygen, an I.V. cardiac glycoside, I.V. furosemide, I.V. morphine sulfate and, when necessary, I.V. nitroprusside and intubation. Maintenance therapy may include an oral nitrate and an angiotensin-converting enzyme inhibitor, such as captopril or enalapril.
Systemic embolization requires anticoagulation therapy or embolectomy.
Refractory ventricular tachycardia, heart failure, recurrent arterial embolization, and persistent angina with coronary artery occlusion may require surgery; the most effective procedure is aneurysmectomy with myocardial revascularization.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Aneurysm, abdominal:
Treatment
(Handbook of Diseases)
Usually, an abdominal aneurysm requires resection of the aneurysm and replacement of the damaged aortic section with a Dacron graft. If the aneurysm is small and produces no symptoms, surgery may be delayed; however, small aneurysms may rupture. A beta-adrenergic blocker may be administered to decrease the rate of growth of the aneurysm. Regular physical examinations and ultrasound checks are necessary to detect enlargement, which may prestage a rupture. In asymptomatic patients, surgery is advised when the aneurysm is 5 to 6 cm (2 " to 2¼") in diameter. In symptomatic patients, repair is indicated regardless of size. In patients with poor distal runoff, external grafting may be done. (See Endovascular grafting for repair of an abdominal aortic aneurysm.)
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Aneurysm, cerebral:
Treatment
(Handbook of Diseases)
The risk of vasospasm and cerebral infarction is reduced by repairing the aneurysm. Usually, surgical repair (by clipping, ligating, or wrapping the aneurysm neck with muscle) takes place 7 to 10 days after the initial hemorrhage; however, surgery performed within 1 to 2 days after the hemorrhage has also shown promise in grades I and II aneurysms.
When surgical correction is risky, when the aneurysm is in a dangerous location, or when surgery is delayed because of vasospasm, treatment includes:
bed rest in a relaxing environment that allows the patient to participate in activities that reduce stress and allow for stabilization of blood pressure (If immediate surgery isn’t possible, bed rest may continue for 4 to 6 weeks.)
avoidance of coffee, other stimulants, and aspirin
codeine or another analgesic as needed
CLINICAL TIP: To avoid the constipating effect of codeine, a stool softener is crucial to prevent straining and resultant rebleeding.
hydralazine or another antihypertensive if the patient is hypertensive
a calcium channel blocker to decrease spasm
a corticosteroid to reduce edema
phenytoin or another anticonvulsant
phenobarbital or another sedative
aminocaproic acid, a fibrinolytic inhibitor, to minimize the risk of rebleeding by delaying blood clot lysis. However, this drug’s effectiveness has been disputed.
After surgical repair, the patient’s condition depends on the extent of damage from the initial hemorrhage and the degree of success of the treatment of resulting complications. Surgery can’t improve the patient’s neurologic condition unless it removes a hematoma or reduces the compression effect.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Aneurysm, thoracic aortic:
Treatment
(Handbook of Diseases)
A dissecting aneurysm is an emergency that requires prompt surgery and stabilizing measures: an antihypertensive such as nitroprusside; a negative inotropic agent that decreases contractility force, such as propranolol; oxygen for respiratory distress; a narcotic for pain; I.V. fluids; and, possibly, whole blood transfusions.
Surgery consists of resecting the aneurysm, restoring normal blood flow through a Dacron or Teflon graft replacement and, with aortic valve insufficiency, replacing the aortic valve.
Postoperative measures include careful monitoring and continuous assessment in the intensive care unit, an antibiotic, endotracheal (ET) intubation, chest tube insertion, ECG monitoring, and pulmonary artery (PA) catheterization.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Abdominal mass:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient has a pulsating midabdominal mass and severe abdominal or back pain, suspect an aortic aneurysm. Quickly take his vital signs. Because the patient may require emergency surgery, withhold food and fluids until the patient is examined. Prepare to administer oxygen and to start an I.V. infusion for fluid and blood replacement. Obtain routine preoperative tests, and prepare the patient for angiography. Frequently monitor blood pressure, pulse, respirations, and urine output. Be alert for signs of shock, such as tachycardia, hypotension, and cool, clammy skin, which may indicate significant blood loss.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Abdominal mass:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Offer emotional support to the patient and his family as they await the results of diagnostic testing.
▪ Position the patient comfortably, and administer drugs for pain or anxiety as needed.
▪ If an abdominal mass causes bowel obstruction, watch for indications of peritonitis—abdominal pain and rebound tenderness—and for signs of shock, such as tachycardia and hypotension.
▪ Prepare the patient for surgery, if indicated.
Patient teaching
▪ Explain any diagnostic tests that are needed.
▪ Teach the patient about the cause of the abdominal mass, once a diagnosis is made. Also explain treatment and potential outcomes.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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