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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
Adequacy of circulating blood volume: cardiac output
This is the volume of blood that is being pumped by the heart in one minute
26
What is cardiac output
The amount of blood that is pumped per minute and is measured in liters
27
What is the formula for cardiac output
Stoke volume x heart rate
28
When does cardiac output increase and when does it decrease
Increase: excerise Decreases: sleep
29
What is usually the cardiac output in an adult
5-6 liters
30
What might cause too much of an increase of cardiac output
Increase sodium levels Kidney not working
31
Increase cardiac output and increased sodium levels (hypernatremia)
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
32
Increase cardiac output and kidney
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
33
Blood viscosity
Hyperglycemic: Sickle cell anemia Diabetes Polythycemia Atrial fibrillation Sedentary lifestyle
34
Hyperglycemic and blood viscosity
High blood sugar causes the blood to be more thick
35
Sickle cell anemia and blood viscosity
The red blood cells are shaped odd making the blood ore likely to clump
36
Polythycemia and blood viscosity
This when there is are more red blood cells being created this makes the blood become thicker
37
Atrial fibrillation and blood viscosity
The heart quivers making the blood become more turbulent or stagnant making it pool more. Increase risk of clots
38
Sedentary lifestyle and clotting of the blood
Not moving a lot make you more prone to bloodclot
39
Factors affecting cardiopulmonary function
Heath Developmental considerations Medication Lifestyle considerations Social determinants of health Psychological Health
40
Older adults and perfusion
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
41
Infants and perfusion
The chest is small so the airways are short and there is aspiration problem Respiratory rate is more rapid
42
If an infant is born before 3 weeks what might happen
May have not produced enough surfactant leading to collapsed alveoli and poor exchange. Pulse rate is more rapid
43
Lifestyle considerations
Smoking.: COPD Cultural influences can encourage or discourage healthy choices Activity level
44
Social determinants
Unsafe air Toxic levels Air pollution Occupational exposure Language barrier Literacy Social isolation a Access to physical activity
45
Psychological health considerations
High stress may experience hyperventilation Anxiety Respiratory problems hypoxia
46
Normal perfusion indicators
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
What is the normal urine output
30 ml per hour
48
BUN and Creatinine with kidney function
As they increase the kidney function is decreasing
49
How much urine output after 8 hour
240
50
What does D-dimer show
It increases with blood clot. It should be low
51
What does PT/PTT show
Blood clotting too quick or too slow
52
What are the 5 p’s you should check for adequate perfusion
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
Factors that impact perfusion
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
What is paresthesia
Numbness or tingling Pins and needles
55
Hypervolemia and perfusion
This is when there is too much fluid in the body and can cause kidney function issues Edema
56
Ventricle contractility issues
Loss of myocardial contractile force Acute ischemia Conduction abnormalities acute
57
Chronic ventricular contractility issues
Ventricular remodeling Endocarditis Pericarditis Valvular disorder
58
Ventricular remodeling
The vessel becomes thicker and weaker Increasing resistance
59
Increased or decrease systemic vascular resistance
Increase: Decrease: Hypovolemia cause the vessel to vessel to enlarge and vasodilation
60
Conditions that impact cellular gas exchange and nutrient exchange
Hypoventilation Edema Pulmonary edema Collapsed alveoli
61
What makes the source of the issue cardiac output
Hypovoleemic Hylervolemic
62
What makes it a cardiopulmonary issue
Ventricle or heart issue Issue with gas exchange Ventricle contractility issues Increased to decreased systemic vascular resistance
63
Vasoconstriction and blockage of the arteries or capillaries
Atherosclerosis Thrombosis Thickened blood due to hyperglycemia
64
Hyperglycemia and thickened blood
Fat deposits
65
Non modifiable risk factors for impaired perfusion
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
Hypertension and systemic vascular resistance
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
Modifiable risk factors
Cigarettes smoking Obesity Diabetes Alcoholism Sedentary lifestyle Hyperlipidemia, Hdl, ldl. Total cholesterol, triglycerides Hypertension or hypotension Blood clots Anemia Dehydration
68
Cigarettes smoking and impaired perfusion
It constrict the blood vessels causing the blood flow to be reduced
69
Obesity and impaired perfusion
The heart begins to work harder because there is a fat build in the vessels from hyperlipidemia causing lack of perfusion
70
What does HgbA1C tells us
Blood glucose level over a 3 month period
71
Alcoholism and perfusion
Narrow blood vessels cause hormones are being release that constrict the blood vessels
72
HDL LDL
Hdl is good LDL is bad
73
Atherosclerosis
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
Blood pressure and the normal range
The force if extended on the arterial walls by the blood flowing within the vessel <120/80
75
Hypertension
Greater than 130/80
76
Hypotension
Less than 90/60
77
Mean arterial pressure
Maintain the blood flow to the tissues throughout the cardiac cycle 70-100
78
Hemoglobin
12-15
79
Hematocrit
35-45%
80
Platelet count
140,000 to 400,000
81
D dimer
Less than 0.5 Tells us about blood clot. If it High not good
82
Total cholesterol
Less than 200
83
LDL
Less than 100
84
HDL
More than 40
85
Triglycerides
Less than 150
86
HgbA1C
Less than 6.4 %
87
Glucose
70-99
88
Prothrombin time (PT)
11.5-15 sec
89
PTT
23-37.5 sec
90
Blood urea nitrogen (Bun
6-20
91
Creatinine
0.5-1.0
92
Complications related to impaired perfusion
Decrease perfusion Inadequate peripheral perfusion Inadequate central perfusion
93
Ischemia vs infarction and pain
Ischemia is decreased perfusion Infarction is complete tissue death due to decrease perfusion that is severe You’re going to have pain
94
Inadequate peripheral perfusion
Lower extremities No pulses or weka pulse Pale, cyanosis Skin ulcers and so forth take a longer time to heal properly
95
Inadequate central perfusion
Can cause stroke, mi, heart failure, shock because of the lack of blood flow to the major organs
96
A narrowing of the blood vessel may cause
Weak pulses Slow cap refill
97
Decresed venous return may cause
The blood is not being returned back to heart in time so it causes edema
98
Thrombocytopenia
Decrease platelet so the patient will bleed alot
99
Oxygenation
Gas exchange is dependent on perfusion the lungs
100
Nutrition
Healthy blood vessels, RBC, iron
101
Fluid and electrolytes
Altercations in the fluid and electrolytes may cause changes to cardiac function affecting perfusion
102
Mobility
Increases risk for blood clot
103
Mental health
Indicator of lack of perfusion to the brain Vascular dementia
104
Interventions
Teach the patient healthy lifestyle habits Monitor perfusion and oxygen exchange Administer medication to improve blood flow
105
Monitoring patient worship and oxygenation status
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
Signs and symptoms of impaired tissue perfusion
Shortness of breath Pain Paralysis No pulse Pain Numbness
107
How much fluid intake per day
2-3 liters
108
Ischemia is commonly caused by
Atherosclerosis

Fundamentals (Nurs 113) (11 decks)

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