Perfusion Flashcards
What is Cardiac Output (CO)?
The total amount of blood ejected from one ventricle of the heart in liters per minute (L/min).
How is Cardiac Output calculated?
Cardiac Output (CO) = Stroke Volume (how much) X Heart Rate (how fast).
What factors affect cardiac output?
- Vasoconstriction
- Compliance of the arteries
- Volume of blood entering the heart from the veins
Define Peripheral Vascular Disease (PVD).
Conditions that result in altered blood flow outside the brain and heart.
What are the two types of Peripheral Vascular Disease?
- Chronic Venous Disease (CVD)
- Peripheral Arterial Disease (PAD)
What characterizes Chronic Venous Disease (CVD)?
Damaged, occluded, or congenitally altered veins.
What is Peripheral Arterial Disease (PAD)?
Damaged, inflamed, or occluded arteries.
What are the consequences of Peripheral Venous Disease?
- Venous stasis
- Increased venous pressure
- Thrombus
- Incompetent valves
- Damage to tissue (ulcer formation)
What are the signs of poor venous perfusion?
Signs include venous stasis and increased venous pressure.
Identify some cues for assessing Peripheral Venous Disease.
- Smoking/Tobacco
- Obesity
- Pregnancies
- Injury
- Leg Pain
What are some treatments for Peripheral Venous Disease?
- Compression therapy
- Meticulous foot care
- Leg exercises
- Elevation of lower extremities
- Weight reduction (if needed)
What are invasive treatments for Peripheral Venous Disease?
- Vein stripping
- Sclerotherapy
- Laser ablation
What is the goal of caring for clients with Peripheral Vascular Disease?
Control or decrease manifestations of the disease, such as pain and edema.
What is Peripheral Artery Disease (PAD)?
A progressive disorder that affects blood flow to the arteries in the lower extremities.
What is a common cause of Peripheral Artery Disease?
Atherosclerosis.
What are the components of an ECG?
- P Wave
- PR Interval
- QRS Complex
- ST Segment
- T Wave
- QT Interval
What does the P Wave represent in an ECG?
Electricity passing through the atrium and atrial contraction.
What indicates Sinus Bradycardia?
Heart rate less than 60 bpm with P waves present.
What are some risk factors for Sinus Bradycardia?
- Myocardial Infarction
- Sleep apnea
- Increased intracranial pressure
- Certain medications
What is the primary function of blood pressure?
The force exerted by the blood against the walls of the blood vessel, required for adequate tissue perfusion.
What are the types of hypertension?
- Primary
- Secondary
What are some modifiable risk factors for hypertension?
- High Sodium Intake
- Smoking
- Obesity
- Alcohol Use
- Physical Inactivity
What is the DASH diet?
A dietary approach to stop hypertension, emphasizing low sodium.
What is the Ankle Brachial Index used for?
Assessing blood flow in the lower extremities.
What does the QT Interval represent in an ECG?
The entire electrical depolarization and repolarization of the ventricles.
What are the signs of Acute Limb Ischemia?
- Pain
- Pallor
- Pulselessness
- Paralysis
- Poikilothermia
What is the goal of interventions for Sinus Tachycardia?
Ensure cardiac output is adequate to provide perfusion of blood to all vital organs.
What is the primary goal of hypertension management?
Achieve and maintain the goal blood pressure
Goal blood pressure is defined as the target level of blood pressure that healthcare providers aim to achieve for patients with hypertension.
What are key lifestyle modifications for managing hypertension?
- Dietary changes (DASH diet, low sodium)
- Weight reduction
- Increased physical activity
- Decreased alcohol use
- Smoking cessation
The DASH diet emphasizes fruits, vegetables, whole grains, and lean proteins while reducing sodium intake.
What pharmacological treatments are commonly used for hypertension?
- ACE inhibitors
- Beta-blockers
- Calcium channel blockers
- Diuretics
Each category of medication works through different mechanisms to lower blood pressure.
What is the mechanism of action for ACE inhibitors?
Slows the activity of the ACE enzyme, promoting vasodilation and decreasing blood pressure
Examples of ACE inhibitors include lisinopril and captopril.
What are common side effects of ACE inhibitors?
- Dry cough
- Fatigue
- Dizziness
- Headache
- Angioedema (Emergent)
Angioedema is a serious side effect that requires immediate medical attention.
What is the action of beta-blockers?
Decreases SNS effects, heart rate, and contraction force
Examples include metoprolol and labetalol.
True or False: Beta-blockers can mask symptoms of hypoglycemia.
True
This is important for diabetic patients who may not recognize low blood sugar levels.
What is the role of calcium channel blockers in hypertension?
Blocks calcium from entering cells, promoting smooth muscle relaxation and decreasing systemic vascular resistance
Diltiazem is an example of a calcium channel blocker.
What are the nursing implications for loop diuretics?
- Assess blood pressure and hold for SBP < 90 mmHg
- Monitor K+ levels
Loop diuretics include furosemide and bumetanide.
What is the significance of potassium levels when administering diuretics?
Monitor K+ levels and notify HCP for levels < 3.5 or > 5.5
Hypokalemia can lead to serious complications, while hyperkalemia can occur with potassium-sparing diuretics.
What defines gestational hypertension?
SBP ≥ 140 mmHg or DBP ≥ 90 mmHg, developing after 20 weeks gestation
Returns to normal within 6 weeks postpartum.
What are the signs of severe pre-eclampsia?
- SBP > 160
- Proteinuria 3+ or greater
- Severe headache
- Epigastric pain
- Visual disturbances
- Fetal growth restriction
Severe pre-eclampsia requires immediate medical intervention.
What is the primary treatment for severe pre-eclampsia?
Delivery is the only cure and often necessary
Medications such as hydralazine, nifedipine, and magnesium sulfate are also used.
What are common symptoms of right-sided heart failure?
- Peripheral edema
- Abdominal ascites
- Hepatomegaly
- JVD
Right-sided heart failure often results from left-sided heart failure.
Fill in the blank: The inability of the heart to provide adequate oxygenation needs to tissues and organs is called _______.
Heart Failure
Heart failure can be classified as left-sided, right-sided, or both.
What factors contribute to heart failure?
- Hypertension
- Coronary artery disease
- Uncontrolled arrhythmias
- Heart valve disease
- Myocardial infarction
These factors can lead to either systolic or diastolic dysfunction.
What are the assessment cues for heart failure?
- Fatigue and activity intolerance
- Dyspnea
- Tachycardia
- Edema
- Nocturia
- Skin changes
- Behavioral changes
- Chest pain
- Weight gain
These symptoms can vary based on the severity of heart failure.
What are the key interventions to decrease hospital readmissions?
Interventions should focus on:
* Controlling and monitoring manifestations
* Adhering to medications
* Dietary restrictions
* Tracking daily weights
These interventions are essential for managing heart failure effectively.
What are the goals of evaluating outcomes in heart failure management?
Goals include:
* Weight maintained
* Decreased edema
* Decreased hospital readmission
* Improved quality of life
These goals help assess the effectiveness of treatment strategies.
What are some negative consequences of heart failure?
Negative consequences include:
* Pulmonary edema
* Pleural effusion
* Dysrhythmias
* Hepatomegaly
* Renal failure
These complications can severely impact a patient’s health.
What occurs in pulmonary edema?
Engorgement of the pulmonary system leads to:
* Interstitial edema
* Fluid containing RBC’s moves into alveoli
* Decreased oxygenation
* Respiratory acidosis
Pulmonary edema is life-threatening and requires immediate medical attention.
What are the signs and symptoms of pulmonary edema?
Signs and symptoms include:
* Dyspnea
* Orthopnea
* JVD
* Anxiety
* Cyanosis/Pallor
* Frothy pink sputum
* Crackles
* Tachypnea (Resp. Rate > 30)
Recognizing these symptoms can facilitate prompt treatment.
Which diagnostic tests are used for heart failure?
Diagnostics include:
* History and physical examination
* Chest x-ray
* 12-lead ECG
* Echocardiogram
* Nuclear imaging
* Heart catheterization
* Serum chemistries (CBC, lipid profiles)
* Cardiac biomarkers (BNP)
* Liver function test
* Thyroid function test
These tests help identify the severity and underlying causes of heart failure.
What are the treatment goals for managing heart failure?
Treatment goals include:
* Identification and treatment of underlying causes
* Maximize cardiac output
* Decrease symptoms
* Improve quality of life
* Preserve organ function
* Decrease mortality rate
Focusing on these goals can lead to better patient outcomes.
What medications are commonly used in heart failure management?
Medications include:
* Diuretics
* ACE Inhibitors
* Beta Blockers
* Vasodilators
* Positive Inotropes
Each class of medication has specific roles in managing heart failure symptoms.
What are the nursing implications for administering vasodilators?
Nursing implications include:
* Assess blood pressure and hold for SBP < 90 mmHg
* Monitor for signs of hypotension (increased dizziness)
Close monitoring is critical to avoid adverse effects.
What are the implications for administering positive inotropes?
Nursing implications include:
* Assess heart rate and hold for HR < 50 bpm
* Monitor digoxin level (0.5-2 ng/dl)
* Assess for signs of digoxin toxicity
Digoxin toxicity can lead to severe complications.
What are the side effects of loop diuretics?
Side effects include:
* Increased dizziness or orthostatic effects
* Hypokalemia and electrolyte disturbances
* Weakness, thirst, muscle cramps, and hypotension
Monitoring is essential to manage these side effects effectively.
What are the characteristics of Coronary Artery Disease (CAD)?
CAD is characterized by:
* Atherosclerosis affecting coronary arteries
* Hardening of the arteries due to lipid deposits
* Injury and inflammation as major contributing factors
Understanding CAD is critical for prevention and management.
What are the major chronic causes of injury leading to CAD?
Major causes include:
* Hypertension
* Tobacco use
* Hyperlipidemia
* Hyperhomocystenemia
* Diabetes
* Infections
* Toxins
Addressing these factors can help prevent CAD.
What are the risk factors for CAD?
Risk factors include:
* Non-Modifiable
* Modifiable
Identifying risk factors is key for prevention strategies.
What are the primary, secondary, and tertiary prevention strategies for CAD?
Prevention strategies include:
* Primary: Health promotion, dangers of smoking, dietary education
* Secondary: Cholesterol screenings, blood pressure screenings, diabetes screening
* Tertiary: Minimizing negative consequences after a major event
Each level of prevention plays a crucial role in managing CAD.
What lifestyle modifications are key for CAD management?
Key lifestyle modifications include:
* Decreasing LDL cholesterol
* Moderate exercise (30 min., 5 days/week)
* Stress reduction
* Smoking cessation
* Weight control (BMI 18-24.9)
These changes can significantly reduce the risk of CAD.
What are the therapeutic uses of cholesterol-lowering drugs?
Therapeutic uses include:
* Treating hypercholesterolemia
* Inhibiting coronary events
* Safeguarding against stroke and heart attack
Effective management of cholesterol levels is crucial for heart health.
What are the characteristics of chronic stable angina?
Characteristics include:
* Pain lasts 3 to 5 minutes
* Subsides when precipitating factor is relieved
* Pain at rest is unusual
* ECG may show ST-segment depression and/or T-wave inversion
Recognizing angina can help in timely treatment.
What is the most common form of valvular heart disease?
The most common form is:
* Mitral Valve Prolapse
While usually benign, it can lead to serious complications.
What are the classic symptoms of mitral valve prolapse?
Classic symptoms include:
* Heart murmur (caused by regurgitation)
* Symptoms in 10% of patients
Early detection can help manage potential complications.
