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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 Hrrak, MA
Tallinn Health Care College, Estonia

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

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

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.

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
headaches, low back pain, stiff neck,
aneurysm
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)
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
Endovascular therapy
care
(2) of arterial blood
monitoring

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

Experience

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

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).

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