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Exam 1 2700 > Perfusion > Flashcards

Perfusion Flashcards

1
Q

What is Perfusion?

A

refers blood flow to a capillary bed to provide nutrients and oxygen to tissues and organs.

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2
Q

What is circulation?

A

refers to flow of blood throughout the heart and blood vessels

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3
Q

Trace the path of normal electrical impulses of the heart

A

Sinoatrial node (right atrium) →atrioventricular node- travels through the bundle of his and purkinje fibers (right/left ventricle)

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4
Q

Describe the structure and function of arteries.

A

they have thick, elastic walls that allow them to stretch during cardiac contraction (systole) and recoil when the heart relaxes (diastole)

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5
Q

describe the structure and function of veins.

A

thin, muscular, but inelastic walls that collapse easily. These walls contract or relax in response to feedback from our sympathetic nervous system (for example, when blood volume is low)

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6
Q

Describe the structure and function of capillaries

A

are microscopic vessels that are only one cell thick. They have extremely thin walls which provide blood flow to every cell in the body.

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7
Q

how does blood volume affect veins?

A

When blood volume is low, the veins contract to provide a smaller space for smaller volume of blood; when blood volume is high, veins relax and enlarge to accommodate increased volume of blood.

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8
Q

What is the importance of diastole to perfusion of the heart?

A

The heart has its own blood supply through the coronary arteries. The coronary sinus fills with blood during diastole. From the coronary sinus, blood flows into the two main coronary arteries which branch into several sections to supply the heart with blood.

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9
Q

How is the cardiovascular system regulated?

A

By the autonomic nervous system (ANS) and by the control centers in the brainstem

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10
Q

Does poor peripheral perfusion increase the risk for hypoxemia?

A

Yes. If blood is not perfusing there will not be adequate oxygen given to the organs.

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11
Q

what is the normal BP range of a newborn?

A

(65-78)/(41-52)

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12
Q

what is the normal BP range of a toddler?

A

(86-120)/ (44-76)

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13
Q

what is the normal BP range of a school aged child?

A

(98-130)/ (58-90)

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14
Q

What is the normal pulse range of a newborn?

A

80-180

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15
Q

what is the normal pulse range of a toddler?

A

110 (80–150)

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16
Q

what is the normal pulse range of a 2-10 year old?

A

60- 110 (from ATI)

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17
Q

what is the normal pulse range for adolescent?

A

80 (55–105)

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18
Q

what affect does aging have on perfusion?

A
  • Cardiac efficiency gradually declines as the heart muscle loses contractile strength and the heart valves become thicker and more rigid.
  • The peripheral vessels become less elastic which creates more resistance to ejection of the blood from the heart.
  • As a result, the heart becomes less able to respond to increased oxygen demands.
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19
Q

what affect does stress have on perfusion?

A
  • a stress response stimulates the release of catecholamines from the sympathetic nervous system.
  • This leads to increased heart rate and contractility, vasoconstriction, and increased tendency of blood to clot. - Prolonged stress sustains the stimulation of the SNS and can lead to cardiovascular disease
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20
Q

what affect do Allergic Reactions and Air Quality have on perfusion?

A
  • blood vessels dilate in areas affected,
  • eosinophils and neutrophils are attracted to the reaction site
  • local tissues are damaged, capillaries become more permeable, resulting in fluid leak into tissues, local smooth muscle cells contract
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21
Q

what affect does altitude have on perfusion?

A
  • Increases production of red blood cells
  • increases vascularity of body tissues
  • increases ability of tissue cells to use oxygen even when atmospheric pressure is low.

altitude is good for perfusion.!

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22
Q

what affect does heat have on perfusion?

A
  • causes vasodilation, which increases cardiac output and oxygenation.
  • heat also increases metabolism.
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23
Q

what affect does cold have on perfusion?

A
  • slows cell metabolism, reducing O2 demand.
  • It also causes vasoconstriction and slows the heart rate. (Induced hypothermia is used in some medical and surgical procedures for those reasons).
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24
Q

What might a nurse notice when assessing a newborn’s perfusion?

A

They may have a bluish coloration of the hands and feet; this is normal and usually disappears within a few hours of birth. Newborns must adapt to the change from placenta blood flow to an independent circulation. This causes poor peripheral circulation, hence, the blue hands and feet.

25
Q

What are some risk factors for impaired perfusion the nurse would assess for the presence of in children and adolescents?

A
  • Tobacco use can be a factor in adverse effects on the cardiovascular system in school aged children.
  • a diet high in sugar and fat can contribute to health perfusion issues in young adults.
  • Sedentary lifestyle can also contribute to different cardiovascular disorders. ( pg. 972)
26
Q

why might pregnancy negatively affect perfusion?

A

a woman’s blood volume increases by 30% while pregnant to have enough blood to adequately supply her and baby, but if the mother is iron deficient she cannot produce the necessary hemoglobin.

27
Q

how might obesity affect perfusion?

A
  • increases your risk of atherosclerosis and hypertension.
  • Excess fat stores reduce its efficiency as a pump.
  • The workload of the heart is also increased by having to perfuse the excess body tissues.
28
Q

how might tobacco use affect perfusion?

A

Tobacco use is a major risk factor in several chronic cardiovascular conditions:
- stroke,
- peripheral arterial disease - aortic aneurism
- heart disease.
Smoking has been shown to cause atherosclerosis, hypertension, and decreased HDL (good) cholesterol.

29
Q

how might substance abuse affect perfusion?

A
  • Large amounts of alcohol depress the cardiac center of the brain.
  • Chronic alcohol abuse causes fatty infiltration of the heart muscle, thrombi (a stationary blood clot along the wall of a blood vessel, frequently causing vascular obstruction) in the coronary arteries, heart enlargement, and dysrhythmias, all of which can lead to heart failure.
30
Q

how does heart failure affect perfusion?

A
  • occurs when the heart becomes an inefficient pump and is unable to meet the body’s demands.
  • Blood is oxygenated when it passes through the lungs, but it is not well circulated to the organs and tissues.
  • Impaired circulation leads to systematic and pulmonary edema, which further impairs gas exchange.
31
Q

how does Coronary Artery Disease (CAD) affect perfusion?

A
  • Plaque builds up in the arteries.
  • This plaque narrows the arteries, reducing blood flow to the heart muscle and making it more likely that clots will form and block the arteries.
32
Q

How does Peripheral Vascular Abnormalities affect perfusion?

A
  • Venous abnormalities disrupt the blood return to the heart.
  • Arterial abnormalities disrupt the flow of oxygenated blood to tissues.
33
Q

Identify techniques a nurse may employ to assess a patient’s perfusion

A
  1. Measuring the blood pressure

2. Palpating the peripheral pulses

34
Q

Why would you look for the presence of anxiety in assessing a patient’s perfusion?

A

A persons heart rate and blood pressure may rise with anxiety. It is important to reduce anxiety because anxiety activates the sympathetic nerve system

35
Q

What signs and symptoms might a nurse see if there is poor peripheral perfusion present?

A
  • The skin may be pale, cyanotic, cool, and shiny
  • hair growth may be sparse
  • there may be clubbing of the nails
36
Q

what is edema?

A

An excessive amount of fluid in the tissues

37
Q

How does a nurse assess a patient for edema?

A
  1. Press firmly with your fingertip for 5 seconds over a bony area, such as the tibia
  2. Release your finger, and observe the skin for the reaction
  3. If edema is present, note the location, degree, and type of swelling
38
Q

what does the P wave represent?

A

represents the firing of the SA node and conduction of the impulse through the atria. In the healthy heart, this leads to atrial contraction

39
Q

what does the QRS complex represent?

A

represents ventricular depolarization and leads to ventricular contraction

40
Q

what does the T wave represent?

A

represents the return of the ventricles to an electrical resting state so they can be stimulated again (ventricular repolarization). The atria also repolarize, but they do so during the time of ventricular depolarization; thus, they are obscured by the QRS complex and cannot be seen on the ECG complex (pg.978)

41
Q

What does the presence of a U wave on an EKG indicate?

A

U waves are not always seen on the EKG, but may be detected with electrolyte imbalance, such as hypokalemia or hypercalcemia. U waves sometimes occur in response to certain medications. Inverted U wave may occur with ischemia (a restriction in blood supply to tissues, causing a shortage of oxygen that is needed for cellular metabolism) to the cardiac muscle

42
Q

define Tachydysrhythmia.

A

an abnormal heart rhythm at a rate of > 100 beats / min

43
Q

define Bradydysrhythmia.

A

an abnormal heart rhythm at a rate of < 60 beats / min

44
Q

Are tachycardic and bradycardic rhythms always considered dysrthymias? Why or why not?

A

No. Some people have a low or high resting heart rate without distress. It all depends on a person’s baseline heart rate. Keep this in mind before assuming that the heart rate is abnormal.

45
Q

define primary prevention.

A
  • The first level of health care, designed to prevent the occurrence of disease and promote health.
  • Its purpose is to decrease the vulnerability of the individual or population to disease or dysfunction.
46
Q

define secondary prevention.

A

Secondary prevention ranges from providing screening activities and treating early stages of disease to limiting disability by averting or delaying the consequences of advanced disease.

47
Q

What is the primary goal of screening

A

Screening is a secondary prevention because the principle goal is to individuals in an early, detectable stage of disease process. However, screening provides an excellent opportunity to offer health teaching as a primary preventative measure

48
Q

Are there any disadvantages to screening

A

Screening may give a feeling, consciously or unconsciously, of being well taken care of and thereby reduce motivation to take responsibility for ones own health

49
Q

What are some community sites where nurses might participate in providing perfusion screenings

A
  • Community centers
  • schools
  • fire departments
  • governmental bodies
  • etc….
50
Q

What are the roles of an RN when participating in screening?

A
  • Community nurses differentiates among elimination problems, coping and stress-tolerance problems, and health perception-management problems.
  • They also make judgements and inferences about community health, community responses to health situations, and population needs.
51
Q

why is it important to encourage regular exercise?

A
  • reduce the risk of chronic disease
  • to help manage body weight
  • to promote health
  • psychological well-being
  • a healthy body weight.
52
Q

What are some dietary recommendations a nurse may make to promote healthy perfusion?

A
  • Choose and prepare foods with little salt
  • choose carbohydrates wisely
  • choose fats wisely
  • increase daily intake of fruits and vegetables, and whole grains
53
Q

What education would a nurse give to a patient to promote optimal venous return?

A
  • Wear elastic (antiembolic) stockings
  • Positioning techniques to reduce compression of leg veins
  • Different ROM (range of motion) exercises
  • Increasing fluid intake
  • Elevation of lower extremities
54
Q

Identify three strategies that prevent clot formation.

A
  • SCDs and IPCs
  • ROM exercises
  • Positioning techniques
55
Q

What are some of the economic benefits to primary and secondary prevention methods, such as screening?

A
  • less financial burden caused by illness in the community

- investment in the future

56
Q

what are some of the economic disadvantages to primary and secondary prevention methods, such as screening?

A
  • The disadvantages that the community may face is finding the proper staff to do all of these different preventative measures.
57
Q

Are there specific cultural/ethnic groups that should receive targeted perfusion screenings?

A

ethnic minorities:

  • african americans
  • native americans
  • mexican-americans
58
Q

what are some modifiable risk factors?

A
  • diet
  • smoking
  • obesity
  • physical activity
  • substance abuse
  • elevated serum lipids (LDL)
  • diabetes
59
Q

what are some non modifiable risk factors?

A
  • genetics
  • gender
  • age
  • ethnicity

Exam 1 2700 (2 decks)

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