Preoperative Nursing Care for a Patient with Cerebral Artery Aneurysm Rupture

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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.

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Statistics

• 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 32 and
  increases with aging (Yamamoto et al. 2005174).

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Statistics

• 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.

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Nursing problems of a preoperative patient with
ruptured cerebral artery aneurysm

• 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.

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Preoperative nursing care (1)

• 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

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Preoperative nursing care (2)
Endovascular therapy

• 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.

Surgical clipping
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Experience

• Based on the authors own experience, it can be
  said that many pateints with cerebral aneurysm
  rupture have problems in memory abilities and
  perceptual speed.

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Experience

• 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).