Brain Aneurysm: Nursing Overview and NCLEX Guide

A brain aneurysm—also known as a cerebral aneurysm—is a weakened area in the wall of a blood vessel in the brain that causes it to balloon or bulge. If the aneurysm ruptures, it leads to a subarachnoid hemorrhage, which can be life-threatening. Understanding this condition is crucial for every registered nurse (RN) and nursing student preparing for the NCLEX or practicing in critical care settings.

🧠 What Is a Brain Aneurysm?

A brain aneurysm occurs when an artery wall weakens, allowing blood to create a bulge. It can remain stable for years or rupture suddenly. Aneurysms most often form in the Circle of Willis, where cerebral arteries branch and are under high pressure.

⚕️ Causes and Risk Factors

As a nurse or RN, understanding the risk factors helps guide patient education and prevention efforts.

Common causes include:

• Hypertension (chronic high blood pressure)
• Atherosclerosis
• Genetic connective tissue disorders (e.g., Marfan syndrome)
• Head trauma or infection
• Smoking
• Family history of aneurysm

Risk factors nurses should monitor:

• Age (more common in adults 40–60)
• Gender (slightly more common in women)
• Excessive alcohol use
• Drug abuse (especially cocaine)

🚨 Signs and Symptoms

A ruptured brain aneurysm presents suddenly and requires immediate nursing intervention.

Before rupture (unruptured aneurysm):

• Headache (localized or severe)
• Vision changes
• Pain above or behind the eye
• Dilated pupil
• Numbness or weakness on one side of the face

After rupture:

• Sudden, severe “worst headache of my life”
• Nausea and vomiting
• Stiff neck
• Sensitivity to light (photophobia)
• Loss of consciousness
• Seizures

🧩 Diagnostic Tests

For NCLEX review and clinical practice, nurses should know these key diagnostic tools:

• CT scan: Detects bleeding in the brain.
• Lumbar puncture: Identifies blood in the cerebrospinal fluid.
• MRI/MRA: Provides detailed imaging of the aneurysm.
• Cerebral angiography: Gold standard for identifying aneurysm location and size.

💉 Nursing Care and Interventions

As a registered nurse, patient monitoring and prevention of complications are critical.

Pre-rupture care:

• Maintain blood pressure within safe limits.
• Administer antihypertensive medications as prescribed.
• Educate patient on avoiding activities that increase intracranial pressure (e.g., straining, coughing).

Post-rupture (critical care):

• Monitor neurological status frequently.
• Maintain airway and oxygenation.
• Control blood pressure carefully—avoid spikes that could worsen bleeding.
• Administer medications:
  • Nimodipine: Prevents vasospasm.
  • Anticonvulsants: Prevent seizures.
  • Pain control: Manage discomfort safely.

Post-surgical nursing care (after clipping or coiling):

• Monitor for complications such as rebleeding or vasospasm.
• Assess vital signs and neuro status closely.
• Support family and provide education about recovery.

🩺 NCLEX Nursing Priorities

For the NCLEX, remember these priority actions:

1. Assess for sudden neurological changes.
2. Maintain airway and oxygen.
3. Keep the head of bed elevated 30°.
4. Prevent straining and coughing.
5. Administer medications to control blood pressure and prevent vasospasm.

These interventions reflect nursing judgment and prioritization skills tested on the NCLEX.

📚 Nursing Education Tip

For students preparing for the NCLEX or reviewing in a nursing bundle, focus on:

• Recognizing early warning signs of increased intracranial pressure (ICP).
• Differentiating between ischemic stroke and hemorrhagic stroke.
• Understanding pharmacologic management and post-op care.

💬 Key Takeaway for RNs and Nursing Students

A brain aneurysm demands quick recognition and intervention. As a nurse, your role in assessment, monitoring, and patient education can save lives. For RN nurses and NCLEX candidates, mastering this topic builds a solid foundation in neurological nursing care.

✅ FAQ: Brain Aneurysm and Nursing Care