Transcript Preoperative Nursing Care for a Patient with Cerebral Artery

Preoperative Nursing Care for a
Patient with Cerebral Artery
Aneurysm Rupture
Ljubov Kinner
North Estonian Medical Centre Foundation,
Estonia
Mentor: Eha Hõrrak, MA
Tallinn Health Care College, Estonia
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The aim of the current presentation is to
describe the preoperative nursing care for
a patient with cerebral artery aneurysm
rupture.
The aim of the literature review was
focused on the fact that cerebral aneurysm
occurs 3% to 5% of the general
population.
Statistics
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The cause of subarachnoid haemorrhage
is a rupture of an intracranial aneurysm in
75-80% of the cases.
Spontaneous subarachnoid haemorrhage
causes immediate death in about 12-15%
of the cases (Hedlund et al. 2007: 404).
The incidence of aneurysmal rupture is
more common in women than in men by a
ratio of 3:2 and increases with aging
(Yamamoto et al. 2005:174).
Statistics
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In the North Estonian Medical Centre
Foundation in neurosurgery unit 60
subarachnoid haemorrhage cases and 5
unruptured aneurysm cases were
recorded in 2008.
In 2009, 65 subarachnoid haemorrhage
cases and 11 unruptured aneurysm cases
were recorded.
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An intracranial
aneurysm is defined as
abnormal saccular
outpouching or dilatation
of intracranial artery.
If the aneurysm bleeds, it
is classified as a
ruptured intracranial
aneurysm, also known
as a subarachnoid
haemorrhage.
Nursing problems of a preoperative
patient with ruptured cerebral artery
aneurysm
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headaches, low back pain, stiff neck, nausea,
vomiting, cloudiness of consciousness,
photophobia, seizures which can cause
injury, numbness or decreased sensitivity of
the body parts, speech disorder;
self care deficit and constipation due to
limitations of the physical activity;
worry.
Preoperative nursing care (1)
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providing a peaceful and secure
environment,
providing information and its related risk
factors and the nature of the cerebral artery
aneurysm to patient and his/her relatives;
teaching and motivating a preoperative
patient;
prevention of constipation and arterial blood
pressure increase;
Preoperative nursing care (2)
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monitoring of arterial blood
pressure level,
consciousness, body
temperature maintenance,
physical activity limitations,
diet performance;
clarification of preoperative
nursing principles and
information about the
operation nature, the possible
surgery risks and the possible
patient appearance changes.
Endovascular therapy
Surgical clipping
Experience
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Based on the
author´s own
experience, it can be
said that many
pateints with
cerebral aneurysm
rupture have
problems in memory
abilities and
perceptual speed.
Experience
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To reduce anxiety, the information should be
repeated to the patient several times.
It is an advantage if relatives and patients
receive information concurrently, especially
about the illness (Vogelsang et al. 2004: 557).
An important finding is that patients with
cerebral aneurysm rupture have high level of
anxiety.
Anxiety elevates the blood pressure, which
increases the risk for bleeding (Smeltzer et al.
2008: 2228).