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Fundamentals Exam 1 > Perfusion > Flashcards

Perfusion Flashcards

1
Q

perfusion

A

circulation of blood through the vascular bed of tissue

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2
Q

pericardium

A
  • double layer of fibroserous membrane covering the heart
  • anchors heart to surrounding structures, forming pericardial sac
  • snug fit prevents heart from over filling with blood
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3
Q

layers of the pericardium

A
  • inner: partiel pericardium
  • outer: visceral pericardium or epicardium
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4
Q

layers of the heart

A
  • 3 layers
    • endocardium
    • myocardium
    • epicardium
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5
Q

epicardium

A
  • covers entire heart and great vessels
  • than folds over to form the parietal layer, lining the pericardium and adheres to the surface of the heart
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6
Q

myocardium

A
  • middle layer
  • consists of specialized cardiac muscle cells (myofibrils)
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7
Q

myofibrils

A

specialized cardiac muscle cells

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8
Q

endocardium

A
  • innermost layer
  • thin membrane composed of 3 layers
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9
Q

Chambers of the heart

A
  • 4 hollow chambers
  • 2 Atria (R/L)
  • 2 Ventricles (R/L)
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10
Q

Ventricles are separated by…

A

Interventricular Septum

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11
Q

Blood flow through the heart (include all valves/oxygenated blood/arteries/veins)

A
  1. Right Atrium recieves deoxygenated blood from inf/sup vena cava
  2. Right Atrium pumps deoxygenated blood through (AV) tricuspid valve into the Right ventricle
  3. Right Ventricle pumps deoxygenated blood to the lungs through the pulmonary artery (semilunar)
  4. Oxygenated blood empties into Left atrium from lungs and pulmonary veins
  5. Left atrium pumps oxygenated blood into the left ventricle through the bicuspid(mitral) valve
  6. Left ventricle pumps oxygenated blood into the aorta through the aortic valve
  7. Blood flows to the rest of the body
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12
Q

vein

A

blood from body to heart

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13
Q

artery

A

heart to body

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14
Q

Heart sounds are..

A

the sound made when the heart valves close

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15
Q

“lub dub”

A

S1 and S2

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16
Q

S1

A

AV valves closing

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17
Q

S2

A
  • “dub”
  • semilunar (Aortic and Pulmonic) valves closing
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18
Q

AV valves close when…

A

ventricles fill

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19
Q

Semilunar valves close when…

A

ventricles empty

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20
Q

Systole

A
  • Phase of ventricle contraction
  • ventricles filled and contract, expelling blood into aorta and pulmonary artery
  • begins with closure of the AV valves (S1) and ends with the closure of the semilunar valves (S2)
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21
Q

Diastole

A
  • Phase of ventricular relaxation
  • Ventricles relax and fill during atrial contraction
  • begins with the closure of semilunar valves (S2) and ends with the closure of the AV valves (S1)
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22
Q

Murmurs

A

harsh, blowing sounds cause by disruption of blood flow into the heart, between the chambers, or into the vascular system

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23
Q

systolic murmur

A

S1 unclear and S2 amplified

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24
Q

panstolic murmur

A

one beat, no “lub dub”

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25
Q

Who grades murmurs?

A

MD or ARNP - NOT nurses

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26
Q

Documentation of Heart sounds

A
  • do not say “present”
  • “S1 and S2 ausculated clearly, no murmur or extra heart sounds ausculated”
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27
Q

Pulse

A
  • wave of blood created by contraction of the left ventricle
  • Generally represents SV output or the amount of blood that enters the arteries with each ventricular contraction
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28
Q

Compliance of the artery

A

ability to contract and expel

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29
Q

peripheral pulse

A

away from the heart; foot or wrist

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30
Q

central pulse

A

carotid

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31
Q

PMI

A

point of maximal impulse; heart, apex

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32
Q

Pulse locations

A
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33
Q

Pulse: Increased age

A

decreased pulse

34
Q

Pulse: after puberty, men..

A

lower pulse than females

35
Q

Pulse: increased exercise

A

increased pulse (during), decreased pulse (resting)

36
Q

Pulse: high stress

A

high pulse

37
Q

Pulse: high fever

A

high pulse

38
Q

Pulse: hypovolemia

A

(low blood volume) high pulse

39
Q

Pulse: Meds

A

depends

40
Q

Pulse: Position change

A

Usually, low BP, high pulse

41
Q

Pulse: Pathology

A

depends

42
Q

Assessment for Pulse

A
  • fingertip pads
  • radial -most common for adults
  • brachial for infants
  • assess rhythm
  • pulse volume
  • elasticity
  • compare peripheral pulses
  • check apical pulse
  • count pulse for full min w/ infants/children
  • count 30 sec x2 for adults
  • apical-radial pulse - check for deficit
43
Q

Pulse volume

A
  • bounding (strong/hydrated)

OR

  • threading (weak/dehydrated)
44
Q

Elasticity of artery

A
  • Smooth/soft
  • hardened (hardens with age)
45
Q

tachycardia

A

above 100 (anxiety, pain, exercise)

46
Q

bradycardia

A

below 60 (usually athletes)

47
Q

Tip for finding pulse

A

If you can’t find it, take some pressure off

48
Q

Apical-Radial Pulse Deficit

A
  • Apical will never be lower than radial
    • If a difference, there is a pulse deficit
49
Q

Systolic BP

A

pressure in systemic arteries when left ventricle contracts

50
Q

Diastolic BP

A

pressure between contractions - heart at rest

51
Q

AHA Guidelines Recommended BP

A

(Sys) Lower than 120/Lower than 80 (Dia)

52
Q

BP: Baby

A

low BP; increases slowly to puberty

53
Q

BP: males

A

higher BP than women until menopause

54
Q

BP: Blacks

A

higher BP than whites; sensitive to salt

55
Q

BP: Obesity

A

high BP

56
Q

BP: Exercise

A

high BP during exercise

57
Q

BP: Stress

A

high BP

58
Q

BP: diurnal variations

A

BPs lower in AM

59
Q

Types of BP Assessment

A
  • electronic
  • manual
  • doppler - noninvasive
  • arterial line - invasive

locations: usually arm; can use thigh or wrist

60
Q

Where to not take BP

A

limb if injured/diseased, cast or dressing, lymph nodes removed, IV in arm, AV fistula for dialysis

61
Q

BP Measurement

A
  • There is 1 step & 2 step
  • cuff in correct position and correct size cuff
  • Pump up cuff
  • Slowly release pressure
  • Watch manometer and listen for Korotkoff phases
62
Q

Korotkoff Phases

A
  1. 1st tapping sound heard- systolic
  2. swishing/whooshing sound
  3. thump; softer than phase 1
  4. softer blowing muffled sound that fades (some use this as diastolic)
  5. silence/last sound - diastolic
63
Q

Orthostatic Hypotension

A
  • peripheral vasodilation occurs when standing up
  • dizzy, lightheaded, may faint due to decreased blood to brain
  • causes: dehydration, bleeding, BP meds or narcotics
64
Q

How to access for Orthostatic Hypotension

A
  • check BP/Pulse while in supine position
  • Sit up and recheck BP/Pulse
  • Repeat in 3 min and document
65
Q

low ejection fraction

A

high BP due to not a lot of blood being pumped out

66
Q

low CO (cardiac output)

A

low BP, high pulse

67
Q

Perfusion Assessment Documentation

A
  • color and warmth of extremities
  • pulses
  • heart sounds
  • capillary refill
  • presence of edema
68
Q

Diagnostic tests of cardiac function

A
  • Serum cholesterol
  • Stress/Exercise test - chest pain
  • Xray, CT, MRI
  • Echocardiogram - heart activity
  • cardiac catheterization
  • EKG
  • Serum cardiac enzymes
69
Q

RN’s role in diagnostic testing

A

Regardless of which test is being done, the nurse is responsible for the education of the procedure, montioring for appropriate meds, any prep needed.

70
Q

Infant/children considerations for assessing CV health

A
  • pediatric stethoscope in infants
  • thigh & arm BP equal in infants
  • thigh BP 10mmHg higher than arm in children
71
Q

Older Adult considerations for assessing CV health

A
  • skin fragile
  • consider antihypertensive meds
72
Q

Modifiable risks factors for cardiac health

A
  • smoking
  • HTN
  • Hypercholesterolemia
  • Obesity
  • Physical activity
  • Diabetes
73
Q

Non-modifiable risk factors for cardiac health

A
  • age
  • gender
  • race
  • family hx
  • personal health hx
74
Q

Genetic/Ethnic Considerations for Cardiac health

A
  • heart dx runs in families
    • cardiomyopathies
    • CAD:coronary artery dx
    • Atherosclerosis
    • Arrhythmias
  • Blacks at higher risk for heart failure, HTN, low HDL
  • High risk for MI in woman after menopause
  • Men more likely to have MI earier in life
75
Q

Cognition

A

LOC: level of conscientiousness

  • low blood supply to brain; confusion/dizzy
76
Q

Comfort

A

low perfusion may manifest as pain

77
Q

Oxygenation

A

low perfusion can cause respiratory distress

78
Q

Statins

A

inhibits cholesterol biosynthesis

79
Q

Vasodilators

A

cause dilation of blood vessels, lowers BP

80
Q

Beta Blockers

A

block beta-adrenergic sites in heart, lowers BP

81
Q

ACE Inhibitors

A

inhibits vasoconstriction; lowers BP

Fundamentals Exam 1 (8 decks)

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