Info

Rising BP may stress graft suture lines

Propranolol

80-400 mg/day in divided doses

Beta blocker

Used in people with small aneurysms without risk for rupture; decreases rate of AAA expansion

4 Abdominal Aortic Aneurysm Independent

PREOPERATIVE. Teach the patient about the disease process, breathing and leg exercises, the surgical procedure, and postoperative routines. Support the patient by encouraging him or her to share fears, questions, and concerns. When appropriate, include support persons in the discussions. Note that the surgical procedure may be performed on an emergency basis, which limits the time available for preoperative instruction. If the patient is admitted in shock, support airway, breathing, and circulation, and expedite the surgical procedure.

POSTOPERATIVE. Keep the incision clean and dry. Inspect the dressing every hour to check for bleeding. Use sterile techniques for all dressing changes. To ensure adequate respiratory function and to prevent complications, assist the patient with coughing and deep breathing after extubation. Splint the incision with pillows, provide adequate pain relief prior to coughing sessions, and position the patient with the head of the bed elevated to facilitate coughing. Turn the patient side to side every 2 hours to promote good ventilation and to limit skin breakdown.

Remember that emergency surgery is a time of extreme anxiety for both the patient and the significant others. Answer all questions, provide emotional support, and explain all procedures carefully. If the patient or family is not able to cope effectively, you may need to refer them for counseling.

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