Abdominal Aortic Aneurysm Nursing Care Plan & Management


  • An aortic aneurysm is an abnormal dilation of the arterial wall caused by localized weakness and stretching in the medial layer or wall of an artery.
  • The aneurysm can be located anywhere along the abdominal aorta.
  • The goal of treatment is to limit the progression of the disease by modifying risk factors , controlling the BP to prevent strain on the aneurysm, recognizing symptoms early, and preventing rupture.
  1. Prominent, pulsating mass in abdomen, at or above the umbilicus
  2. Systolic bruit over the aorta
  3. Tenderness on deep palpation
  4. Abdominal or lower back pain
Diagnostic Evaluation
  1. Chest radiograph, angiogram, transesophageal echocardiography, and magnetic resonance imaging(MRI).
  2. Duplex ultrasonography or computed tomography (CT)
Primary Nursing Diagnosis
  • Risk for fluid volume deficit related to hemorrhage
Other Diagnoses that may occur in Nursing Care Plans For Abdominal Aortic Aneurysm
  • Acute pain related to surgical tissue trauma
  • Anxiety related to threat to health status
  • Decreased cardiac output related to:
    • changes in intravascular volume
    • increased systemic vascular resistance
    • third-space fluid shift
  • Deficient knowledge (preoperative and postoperative care) related to newly identified need for aortic surgery
  • Ineffective breathing pattern related to:
    • effects of general anesthesia
    • endotracheal intubation
    • presence of an abdominal incision
Medical Management

Medical or surgical treatment depends on the type of aneurysm. For a rupture aneurysm, prognosis is poor and surgery is performed immediately. When surgery can be delayed, medical measures include:

  • Strict control of blood pressure and reduction in pulsatile flow.
  • Systolic pressure maintained at 100 to 120 mm Hg with antihypertensive drugs, such as nitroprusside.
  • Pulsatile flow reduced by medications that reduce cardiac contractility, such as propanolol.
Surgical Management
  • Removal of the aneurysm and restoration of vascular continuity with a graft (resection and bypass graft or endovascular grafting) is the goal of surgery and the treatment of choice for abdominal aortic aneurysms larger than 5.5 cm (2 inches) in diameter or those that are enlarging. Intensive monitoring in the critical care unit is required.
Nonsurgical Intervention
  1. Modify risk factors.
  2. Instruct the client regarding the procedure for monitoring BP.
  3. Instruct the client on the importance of regular physician visits to follow the size of the aneurysm.
  4. Instruct the client that if severe back or abdominal pain or fullness, soreness over the umbilicus, sudden development of discoloration in the extremities, or a persistent elevation of BP occurs to notify the physician immediately.
  5. Instruct the client with a thoracic aneurysm to report immediately the occurrence of chest or back pain, shortness of breath, difficulty swallowing, or hoarseness.
Pharmacologic Highlights
  1. 1-10 mg IV of opioid analgesic (morphine) to relieve surgical pain.
  2. 50–100 mcg IV of opioid analgesic (Fentanyl) to relieve surgical pain.
  3. Antihypertensives and/or diuretics for rising BP may stress graft suture lines.
  4. 80-400 mg/day in divide doses of Beta blocker (propanolol) to use in people with small aneurysms without risk for rupture; decreases rate of AAA expansion