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NUR 333 > E2 Perfusion Cardiovascular & Peripheral Vascular > Flashcards

E2 Perfusion Cardiovascular & Peripheral Vascular Flashcards

1
Q

Afterload

A

the pressure that the heart must work against to eject blood during systole

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2
Q

Cardiac Output =

A

Stroke volume (mL/beat) x heart rate (beats/min)

Volume of blood pumped by the heart in one minute

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3
Q

Ejection fraction

A

The % of blood pumped out of left ventricle with each contraction
Normal = >50%
Heart Failure = <40%

Ex. 100mLs of blood sitting in left ventricle on diastole contract 50% ejected (Normal)

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4
Q

Infarction/ necrosis

A

Obstruction of the blood supply to an organ or region of tissue, typically by a thrombus or embolus, causing local death of the tissue

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5
Q

Ischemia

A

Blood flow decreased leading to insufficient O2 (hypoxia)

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6
Q

Myocardial contractility

A

How hard the heart contracts regardless of stretch factor

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7
Q

Preload

A

the amount of stretch during diastole

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8
Q

Pulmonary embolism

A

Embolism travels to superior vena cava, right atrium, right ventricle, and finally the lungs (gets stuck here)

Can Kill You

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9
Q

Pulse pressure

A

Difference btwn systolic and diastolic pressure

Normal= 1/3 of Systolic

High in older people, atherosclerosis, exercise

Low in severe heart failure, hypovolemia (low blood volume)

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10
Q

Pulsus alternans

A

Regular rhythm but strength of pulse varies with each beat
Ex. Heart failure

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11
Q

Stroke

A

Damage to the brain from interruption of its blood supply

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12
Q

Stoke volume

A

Amount of blood ejected from the left ventricle every pump (mL/beat)

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13
Q

Venous thromboembolism (VTE)

A

Obstruction of a blood vessel by a blood clot that has become dislodged from another site in circulation

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14
Q

Who is at risk for a VTE?

A
  1. Venous stasis (Blood pooling in vein)
  2. Hypercoagulability (Thickened blood)
  3. Endothelial damage (Blood vessel wall)
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15
Q

VTE S/S

A

-localized redness, tenderness, swelling over vein sites
-Warmth, tenderness, firmness of muscle in calf
-Complaints of calf pain with ambulation
-Usually unilateral

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16
Q

Assessment for VTE

A

Palpation for s/s of inflammation/ phlebitis

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17
Q

VTE- Diagnosis (detection)

A

-Obtain history
-Physical assessment
-vascular ultrasound studies
-Ultrasound is the only reliable tool to detect

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18
Q

What can we do as a nurse to prevent/ assess for VTEs?

A

-Assess for symptoms
-Measure calf circumference
-Calf tenderness/phlebitis checks

-Early ambulation
-Thromb-embolic deterrent (TEDS)
-Sequential compression device (SCDs)
-Calf pumps

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19
Q

VTE treatment

A

-Prevention is KEY
-Anticoagulation (levonox or heprin)
-Thrombolytic (lyses a thrombus)
-IVC filter (Vena cava device to catch clots before they get to lungs)

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20
Q

Placement of telemetry leads

A

Snow over grass
Smoke over Fire
Chocolate close to the heart

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21
Q

Murmurs

A

Swooshing sound, problem with valve

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22
Q

Clicks

A

pt has had mechanical valve so hear click on close

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23
Q

Rubs

A

rub of pericardial sac, stratchy

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24
Q

5 P’s of Peripheral vascular checks

A

Pain (0-10)
Pulse (0-4+)
Pallor (color)
Paresthesia (feel)
Paralysis (movement)

25
Q

Nursing implementation for cardiovascular system

A

-Strict I&O
-Oxygen PRN
-Telemetry
-Administer Meds
-Monitor labs (CBC, Lipid panel)
-Implement heart healthy diet (DASH)
-Limit stress
-Prevent thrombus formation

26
Q

Nurse care: Patient teaching for Cardiovascular system

A

-Patient centered
-Set goals and provide resources
-Avoid smoking & Alcohol consumption
- Limit stress
-Control HTN, HLP, DM
-Nutrition
-Exercise

27
Q

Flow of blood into heart

A

-Blood comes into Right atrium
-Right ventricle
-Pulmonary arteries in lungs
-Picks up O2 in lungs
-Pulmonary vein back to heart
-Left atrium
-Left ventricle
-Aorta
-Body tissue

28
Q

Perfusion

A

Passage of fluid through circulatory system or lymphatic system to an organ or tissue

Tissue would die w/o perfusion

29
Q

Alterations in cardiac output:

A
  1. Heart rate
  2. Stroke Volume
  3. Myocardial contractility
30
Q

What are examples of things that can alter Cardiac Output

A

-Medications
-Disease Processes
-Activity

31
Q

Blood Pressure

A

Force exerted by the blood against the blood vessel walls
120/80

32
Q

Cardiopulmonary Resuscitation

A

Compressions-Airway-Breathing
1st Check for pulse then call for help

Rate: 100-120 BMP
Depth: 2 in
Breaths 10-12 Breaths per min
Ratio: 30-2

33
Q

High blood pressure definition not number

A

Pressure in your arteries is higher than it should be

34
Q

Daily variation of BP

A

0000-0300: Lowest
0300-0600: Slow Rise
Wake Up: surge
1000-1800: Highest

35
Q

Modifiable risk factors of HTN

A

-Diabetes Mellitus
-Elevated serum lipids
-Excess Na+ intake
-Obesity
-Sedentary lifestyle
-Stress
-Tobacco & Alcohol Use

36
Q

Nonmodifiable risk factors of HTN

A

-Family History
-Race/Ethnicity
-Increasing age
-Gender
-Chronic kidney disease
-Obstructive sleep apnea

37
Q

Hypertensive pts have increased

A

Cardiac output, peripheral resistance, hematocrit

38
Q

Diagnosis of HTN

A

Average of 2 or more readings on at least subsequent health care visits is above 120/80

might check EKG or CXR

39
Q

Hypertension symptoms

A

-Dizziness
-Headache
-Heart palpations
-nosebleed
-short breath
-anger
-red face
-visual problems
-fatigue
-insomnia
-sore knee
-raised temp

40
Q

Hypertensive crisis

A

BP > 180/110
Severe headache
Dyspnea or chest pain
Dizziness, numbness, weakness
Loss of vision
Difficulty speaking
Nosebleeds
Severe anxiety
Unresponsive

41
Q

What foods have a high sodium content

A

-Cheese
-Condiments (BBQ)
-Soy sauce
-Pickles
-Seasoning salt

42
Q

Hypotension

A

SBP falls below <90mmHG
-Is pt symptomatic? Don’t treat if no

43
Q

Causes of hypotension

A

-Dilation of arteries
-Loss of blood volume
-Failure of heart muscles

44
Q

Symptoms of Hypotension

A

-Skin: pallor, skin mottling, clamminess
-Decreased perfusion to brain: Lightheadedness, dizziness, syncope, confusion
-Blurred vision
-Chest pain: Angina
-increased HR: rapid or weak
-Decreased Urine Output
-N/V

45
Q

Treatment of hypotension

A

Treat the cause
-Vasodilation
-Loss of blood volume
-Failure of heart muscle to pump

46
Q

What type of people get orthostatic hypotension

A

-Those that don’t have hypotension
-Elderly
-Immobilized or bedrest
-Pregnant

47
Q

Diagnosis of orthostatic hypotension

A

-SBP decrease of 20mmHG or more
-DBP decrease pf 10mmHG or more

48
Q

Nursing care for orthostatic patients

A

-Change position slowly/ dangle at bedside
-Don’t cross legs when sitting
-Early ambulation
-If immobile, balance rest and activity
-Perform isometric exercises
-Wear compression hose
-Avoid standing for long periods of time

49
Q

Describe lipids

A

fat-like particles in blood stream

50
Q

Describe cholesterol

A

waxy-fat-like substance found in all cells of body

51
Q

Where is cholesterol made?

A

Liver mainly and diet

52
Q

What is the most common fat in the body?

A

Triglycerides

53
Q

Why do we care about hyperlipidemia?

A

It forms hard deposit inside of arteries called atherosclerosis

Worry about it building up on the arterial walls causing it to narrow and less elastic/ flexible (prevent perfusion)

54
Q

Normal Cholesterol

A

<200mg/dL

55
Q

Normal LDL (Bad guys)

A

<130mg/dL

56
Q

Normal HDL (Good guys)

A

Male >45mg/dL
Females >55mg/dL

57
Q

Hyperlipidemia: Diagnostic Test

A

Test at age 20. Test every 4-6 years

At age 40, assess 10 year risk for experiencing CVD or Stroke

58
Q

Dietary modifications of Hyperlipidemia pt

A

-Reduce saturated and trans fats
-Increase in complex carbohydrates & fiber (whole grains, fruits, veggies)
-Limit major source of cholesterol (red meat, egg yolk, whole milk)
-If you have high triglycerides limits alcohol
-eat fatty fish weekly
-Eat foods other than fatty fish high in OMEGA-3 FATTY ACIDS (soy bean, canola, walnuts, flax seeds)

59
Q

Common perfusion concerns

A
  1. Hypertension
  2. Hypotension
  3. Hyperlipidemia
  4. Venous Thromboembolism (VTE)

NUR 333 (15 decks)

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