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Therapeutics > Circulation > Flashcards

Circulation Flashcards

1
Q

What occurs when atherosclerosis occludes the coronary arteries?

A

Angina or Myocardial Infarction

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2
Q

What is cardiac output (CO)?

A

The amount of blood pumped by the ventricles in 1 minute

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3
Q

What is stroke volume (SV)?

A

The amount of blood ejected with each contraction

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4
Q

What is the normal cardiac output?

A

4 - 8 L/min.

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5
Q

What are some non-modifiable risk factors for Cardiovascular Disease?

A

Heredity (Race, Family History), Age, and Gender

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6
Q

What are some modifiable risk factors for Cardiovascular Disease?

A 
Elevated serum lipid level
Hypertension
Cigarette smoking
Diabetes
Obesity
Sedentary Lifestyle
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7
Q

What are non-traditional risk factors for Cardiovascular Disease?

A

Metabolic Syndrome- central obesity, increased triglycerides, hypercholesterolemia, hypertension, and elevated fasting glucose
C-Reactive Protein at High Levels
Elevated Homocysteine Level- Homocysteine is an amino acid that has been shown to be increased in many people with atherosclerosis

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8
Q

What are three major alterations in cardiovascular function?

A

Cardiac Output
Impaired Tissue Perfusion
Disorders that affect the composition or amount of blood available for transport of gases

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9
Q

How does Myocardial Infarction decrease cardiac output?

A

If a large portion of the heart muscle is affected, particularly in the left ventricle, the affected muscle no longer contracts correctly.

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10
Q

What are signs and symptoms of MI?

A

Chest pain: substernal and/or radiating to the left arm, jaw
Nausea
Shortness of Breath
Diaphoresis

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11
Q

How does Heart Failure decrease cardiac output?

A

Irregular heartbeats:

  • Rapid beats doesn’t allow ventricles may not fill adequately between beats so stroke volume falls
  • Slow heart beat doesn’t have enough force to increase stroke volume to maintain cardiac output
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12
Q

What can left-sided heart failure cause?

A

The vessels of the pulmonary system become congested, causing fluid to escape into the alveoli and interfere with gas exchange, which is pulmonary edema

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13
Q

What are signs and symptoms of Heart Failure?

A 
Pulmonary Congestion: adventitious lung sounds
Shortness of Breath
Dyspnea on Exertion
Increased Heart Rate
S3 Heart Sound
Increased Respiratory Rate
Nocturia
Orthopnea
Distended Neck Veins 
Pitting Edema
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14
Q

What are some causes of impaired tissue perfusion?

A

Atherosclerosis is the most common

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15
Q

What are signs of impaired peripheral arterial circulation in the legs and feet?

A 
decreased peripheral pulse
pain or paresthesias
pale skin color
cool extremities
decreased hair distribution
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16
Q

What are some examples of blood alterations that causes impaired cardiac output?

A
  • Inadequate RBCs
  • Low Hemoglobin
  • Abnormal Hemoglobin Structure (ex. Sickle Cell Anemia)
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17
Q

What are some signs and symptoms of Anemia?

A

Chronic Fatigue
Pallor
Shortness of Breath
Hypotension

18
Q

What is the benefit of auscultating for lung sounds when assessing cardiac function?

A

The nurse can assess for INCREASED PULMONARY VESSEL PRESSURE secondary to decreased cardiac output, as evidenced by adventitious lung sounds.

19
Q

When assessing blood pressure in both arms, what should the nurse assess for and how far apart should the BP on both arms be?

A

Strength and Equality

10 mmHg of each other

20
Q

Why are carotid arteries ausculated?

A

To detect BRUITS, which may indicate ATHEROSCLEROSIS

21
Q

What is hemodynamics?

A

The study of forces or pressures involved in blood circulation. Evaluates fluid status and cardiovascular function.

22
Q

What are some parameters measured directly in hemodynamic using catheters?

A

HR, Arterial Blood Pressure, and Venous Blood Pressure

23
Q

What are some parameters in hemodynamics are calculated?

A

Stroke Volume

Cardiac Output

24
Q

What are some NANDA diagnostic labels for circulation problems?

A
  • Decreased Cardiac Output
  • Risk for Peripheral
  • Neurovascular Dysfunction
25
Q

What happens to the legs during immobility in terms of circulation?

A

Blood Pools in the veins of the lower extremities; Sluggish blood flow may cause VENOUS THROMBOSIS

26
Q

What solution starts out as isotonic, but becomes ______, and how does this happen?

A

5% dextrose solution IN WATER; Hypotonic
-Provides free water when dextrose is metabolized, expanding intracellular and extracellular fluid volumes interstitial space

27
Q

What solution is used to treat metabolic alkalosis?

A

Lactated Ringer’s

28
Q

Which veins are commonly used for Venipuncture Sites for adults? Which ones for children?

A

Adults: Arms
Children: Scalp and Dorsal Foot Veins

29
Q

When performing IVs, select a vein that is…

A
  • Easily palpated and Feels Soft and Full
  • Naturally splinted by bone
  • Large enough to allow adequate circulation around the catheter
30
Q

When performing IV’s Avoid using veins that are…

A
  • In areas of flexion
  • Highly visible, because they tend to roll away from the needle
  • Damaged by previous use, phelbitis, infiltration, or sclerosis
  • Continually distended with blood, or knotted or tortuous
  • In surgically compromised or injured extremity
31
Q

Which veins are common venipuncture sites?

A

Metacarpal, Basilic, and Cephalic vein

32
Q

How are peripheral-short catheter used?

A
  • Usually less than 1 week

- Comes in winged or non-winged

33
Q

What are Over-The-Needle Catheters? What are they also called?

A
  • Plastic catheter fits over the needle used to pierce the skin and vein wall
    - Once inserted into the vein, the needle is withdrawn and discarded leaving the catheter in place
  • Commonly used on adults
  • AKA Angiocatheters
34
Q

What are Buterfly or Wing-up Catheters and how are they used?

A
  • Plastic flaps attached to the shaft are held tightly to hold the needle securely during insertion and secured the tape once inserted
  • Frequently used for short-term therapy
35
Q

What are Peripherally inserted Central Venous Catheter (PICC) and how are they used?

A
  • Inserted in the basilic or cephalic vein just above or below the antecubital space of the right arm
  • Tip of the catheter rests in the superior vena cava
  • Frequently used for long-term IV access whe nthe client will be managing IV therapy at home
36
Q

What are Central Venous Catheter Lines and how are they used?

A
  • Catheter tip is in the central vein and in the superior vena cava
  • Greater ease of movement but more potential complications such as shortness of breath, hypotension, chest pain, cough, tachycardia
37
Q

What are implantable venous access devices and what are they used for?

A
  • Used for clients with chronic illness who require long-term IV therapy such as chemotherapy
  • Used to provide repeat access to the central venous system, avoiding trauma, and complications of multiple venipunctures
  • Surgical implantable ports are surgically placed into a small subcutaneous pocket under the skin near the clavicle
  • No part of the port is exposed
38
Q

What are some reasons someone might use a sequential compression device and what does it do?

A
  • Undergoing surgery
  • Immobilization
  • In critical care unit
    Promote Venous Return From the Legs to Prevent Thrombi and Edema
39
Q

What are reasons Sequential Compression Devices NOT used for?

A

Arterial Insufficiency, Cellulitis, Infection of the Extremity, Active DVT, or Preexisting venous thrombosis

40
Q

How do Sequential Compression Devices work?

A

They inflation and deflation stimulate the blood flow that results from walking and moves the blood back to the heart.

41
Q

What problems do Sequential Compression Devices solve?

A 
Deep Vein Thrombosis (DVT)
Peripheral Edema (PE)

Therapeutics (41 decks)

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