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Fundamentals (Nurs 113) > Introduction To Perfusion > Flashcards

Introduction To Perfusion Flashcards

1
Q

What is perfusion

A

The flow of the blood through the arteries and capillaries delivering nutrients and oxygen to tissues

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2
Q

What is the main goal of perfusion

A

Use the capillaries and arteries to deliver oxygen and nutrients to body tissues

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3
Q

What is peripheral perfusion

A

Blood flow to the extremities of the body. This is like the hands, feet, arms,legs etc

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4
Q

What is central perfusion

A

Blood flow to the major organs including the heart and lungs

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5
Q

What does adequate perfusion depend on:

A

Cardio-pulmonary system
Adequacy of circulatory blood volume (cardiac output)
Blood viscosity

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6
Q

What is the goal of perfusion

A

Is that the cells of the body receives essential nutrients that is required for functioning and metabolism

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7
Q

Efficiency of the cardio- pulmonary system

A

Pulse elasticity
Decreased blood pressure
Perfusion
Physiology of cardiovascular system
Altercations in cardiovascular syste,
Factors affecting cardiovascular system

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8
Q

Pulse elasticity

A

The normal artery should feel smooth, straight and resilient

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9
Q

What causes blood vessels to become less elastic

A

As you get older the blood vessels become less elastic becoming more rigid, less resilient and crooked arterial blood vessel

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10
Q

Hypertension

A

More than 130/80
This is a risk factor for cardiovascular disease, cva, mi, heart failure, peripheral vascular disease and aortic aneurysm

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11
Q

Decreased blood pressure: hypotension

A

Blood pressure below 90/60
The body is unable to maintain or return blood pressure back to normal or in the inability to do is quickly enough.
Vasodilation of the arterioles
Failure of the heart to function as an effective pump
Loss of blood volume (hemorrhage)
Medications
Signs and symptoms

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12
Q

Dehydration and hypotension

A

When you are dehydrated you have less water in your body, causing blood volume which decreases your blood pressure.
The heart will also pump harder to make up for the blood that is not there

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13
Q

Hypovolemia and hypotension

A

Hypovolemia is when there isn’t enough blood in the body which causes less blood circulating in the body. This causes lower venous return lowering the blood pressure

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14
Q

Hypokalemia and hypotension

A

This is when there is low potassium levels in the blood. This causes changes in the heart rhythm and function. Less blood flow low blood pressure

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15
Q

What medications affect hypotension

A

Blood pressure med (Antihypertensive)
Some antidepressants
Anti anxiety medication
Analgesics

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16
Q

Orthostatic hypotension

A

When the blood pressure drops when the patient stands up

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17
Q

Perfusion and lungs

A

The lungs is needed for gas exchange
Oxygen from the air is diffuses into the blood and carbon dioxide from the blood diffuses into the alveoli to be exhaled

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18
Q

Altercations in the respiratory system

A

Hypoxia
Dyspnea
Hypoventilation

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19
Q

Blood flow in the body

A

The blood enters through right atrium from the superior and inferior vena cava.
Blood flows through the tricuspid valve into the right ventricle.
The blood moves through the pulmonary valve into the pulmonary artery
The blood travels to th e lungs where it get oxygenated
The blood return to the heart through the pulmonary vein and enters the left atrium
The blood flow through the mitral valve to the left ventricle
The blood moves from through the aortic valve into the aorta
The blood is distributed throughout the body

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20
Q

Altercations in cardiovascular function

A
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21
Q

Dysthymia (arrhythmia)

A

Disturbance of the rate and or rhythm of the heart.
This is abnormal rate of the electrical implukses generation from the SA node

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22
Q

What do dysrhythmia affect

A

The pumping of the heart, the heart rate, rhythm, interferes with circulation which leads to oxygenation issues

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23
Q

What diseases dysthymia’s occur with

A

Hypertension
Heart disease Damage to the heart
Decreased o2

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24
Q

Ischemia

A

Decreased oxygen wholly to the heart because of insufficient blood supply
Commonly caused by atherosclerosis which is the accumulation of fatty substances in the lining and tub issues in the body which create blockage narrowing the vessels reducing blood flow

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25
Q

Adequacy of circulating blood volume: cardiac output

A

This is the volume of blood that is being pumped by the heart in one minute

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26
Q

What is cardiac output

A

The amount of blood that is pumped per minute and is measured in liters

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27
Q

What is the formula for cardiac output

A

Stoke volume x heart rate

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28
Q

When does cardiac output increase and when does it decrease

A

Increase: excerise
Decreases: sleep

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29
Q

What is usually the cardiac output in an adult

A

5-6 liters

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30
Q

What might cause too much of an increase of cardiac output

A

Increase sodium levels
Kidney not working

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31
Q

Increase cardiac output and increased sodium levels (hypernatremia)

A

Increased sodium levels is caused when there is dehydration. Dehydration reduces the blood volume in the body triggering the body to compensate by increasing cardiac output to maintain blood flow and pefusion

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32
Q

Increase cardiac output and kidney

A

When kidney is not working properly it causes decreased perfusion. With impaired kidney function there can be fluid retention causing sodium to stay in the body. As a result the heart will pump more blood to increase the blood volume and eleventh the blood pressure increaseimg cardiac output

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33
Q

Blood viscosity

A

Hyperglycemic:
Sickle cell anemia
Diabetes
Polythycemia
Atrial fibrillation
Sedentary lifestyle

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34
Q

Hyperglycemic and blood viscosity

A

High blood sugar causes the blood to be more thick

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35
Q

Sickle cell anemia and blood viscosity

A

The red blood cells are shaped odd making the blood ore likely to clump

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36
Q

Polythycemia and blood viscosity

A

This when there is are more red blood cells being created this makes the blood become thicker

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37
Q

Atrial fibrillation and blood viscosity

A

The heart quivers making the blood become more turbulent or stagnant making it pool more. Increase risk of clots

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38
Q

Sedentary lifestyle and clotting of the blood

A

Not moving a lot make you more prone to bloodclot

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39
Q

Factors affecting cardiopulmonary function

A

Heath
Developmental considerations
Medication
Lifestyle considerations
Social determinants of health
Psychological Health

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40
Q

Older adults and perfusion

A

Tissues and airways of the respiratory tract become less elastic.
The respiratory and abdominal muscles are reduced so the diaphragm moves less efficiently
Decline in maximum inspiration and expiration
Airways collapses more easily
Increase risk of disease

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41
Q

Infants and perfusion

A

The chest is small so the airways are short and there is aspiration problem
Respiratory rate is more rapid

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42
Q

If an infant is born before 3 weeks what might happen

A

May have not produced enough surfactant leading to collapsed alveoli and poor exchange.
Pulse rate is more rapid

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43
Q

Lifestyle considerations

A

Smoking.: COPD
Cultural influences can encourage or discourage healthy choices
Activity level

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44
Q

Social determinants

A

Unsafe air
Toxic levels
Air pollution
Occupational exposure
Language barrier
Literacy
Social isolation a
Access to physical activity

45
Q

Psychological health considerations

A

High stress may experience hyperventilation
Anxiety
Respiratory problems hypoxia

46
Q

Normal perfusion indicators

A

Neuro: alert and oriented x4, normal speech, vision, PERRLA
Musc: note strength and movement
Res: normal respirations, 02 and arterial blood gases
Cardiac/VS: normal bp, hr, pulse, electrolytes, capillary refill, normal huh, pt, d dimer
Gastrointestinal : normal bowel sounds, bowel movement and stool appearance
GENITOURINARY: normal urinary output, color, clarity, bun, creatinine
Skin: warm, dry, intact, color, no edema, hair distribution, wound healing, healthy nail

47
Q

What is the normal urine output

A

30 ml per hour

48
Q

BUN and Creatinine with kidney function

A

As they increase the kidney function is decreasing

49
Q

How much urine output after 8 hour

A

240

50
Q

What does D-dimer show

A

It increases with blood clot. It should be low

51
Q

What does PT/PTT show

A

Blood clotting too quick or too slow

52
Q

What are the 5 p’s you should check for adequate perfusion

A

Pain:
Pallor (perfusion): poor arterial perfusion
Peripheral pulses: assess capillary refill especially if pulses can’t be felt
Paresthesia (sensation): numbness and tingling
Paralysis (movement)
Pressure
Blood loss and oze

53
Q

Factors that impact perfusion

A

Hypovolemia
Hypervolemia: fluid overload, edema
Ventricle contractility issues
Increased or critically decreased systemic vascular resistance
Vasoconstriction
Conditions that interfere with cellular gas and nutrient exchange: Hypoventilation, edema
High blood pressure

54
Q

What is paresthesia

A

Numbness or tingling
Pins and needles

55
Q

Hypervolemia and perfusion

A

This is when there is too much fluid in the body and can cause kidney function issues
Edema

56
Q

Ventricle contractility issues

A

Loss of myocardial contractile force
Acute ischemia
Conduction abnormalities acute

57
Q

Chronic ventricular contractility issues

A

Ventricular remodeling
Endocarditis
Pericarditis
Valvular disorder

58
Q

Ventricular remodeling

A

The vessel becomes thicker and weaker
Increasing resistance

59
Q

Increased or decrease systemic vascular resistance

A

Increase:
Decrease: Hypovolemia cause the vessel to vessel to enlarge and vasodilation

60
Q

Conditions that impact cellular gas exchange and nutrient exchange

A

Hypoventilation
Edema
Pulmonary edema
Collapsed alveoli

61
Q

What makes the source of the issue cardiac output

A

Hypovoleemic
Hylervolemic

62
Q

What makes it a cardiopulmonary issue

A

Ventricle or heart issue
Issue with gas exchange
Ventricle contractility issues
Increased to decreased systemic vascular resistance

63
Q

Vasoconstriction and blockage of the arteries or capillaries

A

Atherosclerosis
Thrombosis
Thickened blood due to hyperglycemia

64
Q

Hyperglycemia and thickened blood

A

Fat deposits

65
Q

Non modifiable risk factors for impaired perfusion

A

Age: older adults
-have decrease elasticity of the arterial vessels making them becoming stiff
Age: newborn
- those who have congenital heart abnormalities
Racial and ethic
- African American and Hispanics due to the increased risk of chronic diseases that can affect perfusion such as diabetes, hypertension, hyperlipidemia etc

66
Q

Hypertension and systemic vascular resistance

A

Systemic vascular resistance causes the vessels to become more narrow and it increases with high blood pressure. The ventricle becomes thicker and gets weaker so the blood is not being pumped properly causing lack of perfusion
Narrow blood vessels are constricted

67
Q

Modifiable risk factors

A

Cigarettes smoking
Obesity
Diabetes
Alcoholism
Sedentary lifestyle
Hyperlipidemia, Hdl, ldl. Total cholesterol, triglycerides
Hypertension or hypotension
Blood clots
Anemia
Dehydration

68
Q

Cigarettes smoking and impaired perfusion

A

It constrict the blood vessels causing the blood flow to be reduced

69
Q

Obesity and impaired perfusion

A

The heart begins to work harder because there is a fat build in the vessels from hyperlipidemia causing lack of perfusion

70
Q

What does HgbA1C tells us

A

Blood glucose level over a 3 month period

71
Q

Alcoholism and perfusion

A

Narrow blood vessels cause hormones are being release that constrict the blood vessels

72
Q

HDL
LDL

A

Hdl is good
LDL is bad

73
Q

Atherosclerosis

A

Impaired blood flow as it narrows and obstructs the blood vessels leading to ischemia or inadequate blood supply
Build up of plaque inside the arteries

74
Q

Blood pressure and the normal range

A

The force if extended on the arterial walls by the blood flowing within the vessel
<120/80

75
Q

Hypertension

A

Greater than 130/80

76
Q

Hypotension

A

Less than 90/60

77
Q

Mean arterial pressure

A

Maintain the blood flow to the tissues throughout the cardiac cycle
70-100

78
Q

Hemoglobin

A

12-15

79
Q

Hematocrit

A

35-45%

80
Q

Platelet count

A

140,000 to 400,000

81
Q

D dimer

A

Less than 0.5
Tells us about blood clot. If it High not good

82
Q

Total cholesterol

A

Less than 200

83
Q

LDL

A

Less than 100

84
Q

HDL

A

More than 40

85
Q

Triglycerides

A

Less than 150

86
Q

HgbA1C

A

Less than 6.4 %

87
Q

Glucose

A

70-99

88
Q

Prothrombin time (PT)

A

11.5-15 sec

89
Q

PTT

A

23-37.5 sec

90
Q

Blood urea nitrogen (Bun

A

6-20

91
Q

Creatinine

A

0.5-1.0

92
Q

Complications related to impaired perfusion

A

Decrease perfusion
Inadequate peripheral perfusion
Inadequate central perfusion

93
Q

Ischemia vs infarction and pain

A

Ischemia is decreased perfusion
Infarction is complete tissue death due to decrease perfusion that is severe
You’re going to have pain

94
Q

Inadequate peripheral perfusion

A

Lower extremities
No pulses or weka pulse
Pale, cyanosis
Skin ulcers and so forth take a longer time to heal properly

95
Q

Inadequate central perfusion

A

Can cause stroke, mi, heart failure, shock because of the lack of blood flow to the major organs

96
Q

A narrowing of the blood vessel may cause

A

Weak pulses
Slow cap refill

97
Q

Decresed venous return may cause

A

The blood is not being returned back to heart in time so it causes edema

98
Q

Thrombocytopenia

A

Decrease platelet so the patient will bleed alot

99
Q

Oxygenation

A

Gas exchange is dependent on perfusion the lungs

100
Q

Nutrition

A

Healthy blood vessels, RBC, iron

101
Q

Fluid and electrolytes

A

Altercations in the fluid and electrolytes may cause changes to cardiac function affecting perfusion

102
Q

Mobility

A

Increases risk for blood clot

103
Q

Mental health

A

Indicator of lack of perfusion to the brain
Vascular dementia

104
Q

Interventions

A

Teach the patient healthy lifestyle habits
Monitor perfusion and oxygen exchange
Administer medication to improve blood flow

105
Q

Monitoring patient worship and oxygenation status

A

Monitor the urine for BUN AND CREATININE
Observe for deep vein thrombosis
Monitor vitals
Review labs
Observe lower extremities for edema
Conduct neuro exam
Change in level of consciousness

106
Q

Signs and symptoms of impaired tissue perfusion

A

Shortness of breath
Pain
Paralysis
No pulse
Pain
Numbness

107
Q

How much fluid intake per day

A

2-3 liters

108
Q

Ischemia is commonly caused by

A

Atherosclerosis

Fundamentals (Nurs 113) (11 decks)

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