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N160 exam 3 > Perfusion > Flashcards

Perfusion Flashcards

1
Q

What are the functions of the cardiovascular system?

A

 Promote perfusion of blood thru body
 Carry cellular wastes to excretory organs
 Promote return of blood to heart for oxygenation

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2
Q

What are the signs & symptoms assessed for perfusion?

A 
◦ Chest pain / discomfort
◦ VS
◦ SOB / dyspnea / DOE
◦ Edema / weight gain
◦ Palpitations
◦ Fatigue / weakness
◦ Dizziness / syncope / fainting
◦ Auscultate heart sounds – S1 S2
◦ Carotid artery – palpate individually
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3
Q

What can be the causes of pain for perfusion?

A

◦ Acute Coronary Syndrome
◦ Inflammatory heart disorders
◦ Chest pain non-cardiac causes
◦ Leg pain

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4
Q

Average pressure
 Taking systolic &; diastolic pressures into consideration
 at least 65 mmHg = required for adequate
perfusion

A

Mean arterial pressure

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5
Q

 Systolic BP falls greater than10 mmHg on INSPIRATION
 Can indicate excessive fluid in the pericardial sac
 Restricts normal heart contraction – seen in pericarditis /endocarditis

A

Pulsus paradoxus

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6
Q

 Systolic BP – diastolic BP = ????
 Normal range is 30 to 40 mmHg
 Increasing pulse pressure = atherosclerosis
& exercise
 Decreasing pulse pressure = hemorrhage,
hypovolemia & shock.

A

pulse pressure

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7
Q

 Include measuring the BP & heart rate
 (HR) in 3 positions:
• 1st lying—supine
• 2nd sitting—dangling, and if the patient can tolerate it
• 3rd- standing

A

orthostatic blood pressure

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8
Q

◦ First heart sound

◦Closure of mitral & tricuspid valves

A

S1

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9
Q

◦ Second hearts sound

◦Closing of aortic & pulmonic valves

A

S2

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10
Q

 Ventricular gallop
 Occurs as blood enters noncompliant ventricles in early diastole
 Early sign of heart failure

A

S3

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11
Q

 Atrial gallop
 Occurs as blood enter atrium during atrial contraction
into nonconpliant ventricles at end of ventricular diastole

A

S4

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12
Q

 Summation gallop

 Sign of severe heart failure

A

S3 and S4

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13
Q

◦ Gentle blowing, swooshing sounds

◦ Turbulent blood flow through the valves

A

Murmurs

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14
Q

What are conditions resulting in murmurs?

A

◦Velocity of blood increases
◦Viscosity of blood decreases
◦ Structural defects in the valves
◦Unusual openings in chambers

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15
Q

Murmurs are usually described by their?

A 
 Location
 Timing
 Grading
 Pitch
 Quality
 Radiation
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16
Q
  • abnormal, high-pitched diastolic sounds heard during opening of an AV valve
  • the sound is caused by a high pressure in the left atrium that abruptly displaces open a rigid valve leaflet
    ex. mitral stenosis can cause this
A

opening snap

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17
Q
  • stenosis of one of the semilunar valves creates a short, high-pitched sound in early systole, immediately after S1
  • the result of the opening of a rigid and calcified aortic or pulmonic valve during ventricular contraction
A

systolic click

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18
Q

◦ Friction sound occurring with myocardial contraction

  • a harsh, grating sound that can be heard in both systole and diastole
  • caused by abrasion of the inflamed pericardial surfaces
A

Pericardial Friction Rub

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19
Q

Affected by alteration in any of the following:
preload, afterload, and/or contractility
◦ Defined as the amount of blood ejected by the left
ventricle per beat

A

stroke volume

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20
Q

◦ Stretch in myocardial muscle fibers before systole
◦ Determined by venous return to the heart &
elasticity of cardiac muscle fibers

A

preload

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21
Q

◦ Amount of resistance as blood ejected from

ventricles

A

afterload

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22
Q

Means the force at which the myocardial

muscule cells contract

A

contractility

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23
Q

◦ the percent of blood the left ventricle ejects with each
contraction
◦ Normal range is 55% to 65%.

A

ejection fraction

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24
Q

Normal for CO :

A

4 to 8 L/minute

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25
Q

Normal for SV :

A

60 to 120 ml/beat

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26
Q

Stroke Volume (SV) x Heart Rate (HR)=?

A

Cardiac output

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27
Q

measured by invasive monitoring devices

• Pulmonary Artery Catheter

A

Cardiac output

28
Q

What should be done after blood is drawn?

A

 Monitor venipuncture site for bleeding,
hematoma, phlebitis, and/or infection.
 Watch for lab results
 Report significant abnormalities in results

29
Q

 Neurohormone secreted from ventricles in
response to increased preload
 Serum marker for heart failure
 Results in elevated ventricular pressure
 Normal level should be < 100 pg/mL

A

B-Type Natriuretic Peptide:

30
Q

 Available IV
 nesiritide (Natrecor)
 Used to treat acute heart failure exacerbations
 Causes arterial & venous dilation & diuresis
 Results in decrease in afterload & preload

A

Synthetic BNP

31
Q

Normal range – (PTT):

A

21-35 secs

32
Q

◦ 1.5 - 2.5 times X baseline values (less than 50
increase heparin, over 100 decrease heparin)
◦ Usually 60-100 seconds
(therapeutic=heparinized)

A

Therapeutic PTT (patient on heparin):

33
Q

Normal range – (aPTT):

A

25-35 secs

34
Q

Normal range - (PT) prothrombin time

A

10-13 sec

35
Q

Therapeutic PT, prothrombin time (patient on warfarin) =

A

20-35 secs

36
Q

Normal range- (INR) (not on anticoagulant)

A

<2.0

37
Q

 Therapeutic INR – treatment of heart
disease, venous thrombosis, pulmonary
embolism

A

2.0-3.0

38
Q

Therapeutic INR – patients with

mechanical heart valves or recurrent emboli

A

2.5 - 3.5

39
Q

What are the normal hematocrit ranges for male and females?

A

 Male: 38 – 51%

 Female: 33 – 45%

40
Q

What are the normal hemoglobin ranges for males and females?

A

 Male: 13.2 – 17.3 g/dL

 Female: 11.7 – 15.5 g/dL

41
Q

What are the normal platelet ranges?

A

150,000 – 450,000/mm3

42
Q

What are the normal WBC ranges?

A

4,500 – 11,100/mm3

43
Q

Most influential electrolytes in perfusion:

A

Sodium, Potassium, Calcium, Magnesium

44
Q

What are the normal iron ranges for males and females?

A

 50 to 170 mcg/dL in females

 65 to 175 mcg/dL in males

45
Q

What are the normal ferritin ranges for males and females?

A

 20 - 250 ng/mL in men
 10 – 120 ng/mL in women <40 yr old
 12 – 263 ng/mL in women >40 yr old

46
Q

What are the normal ranges for transferrin?

A

 200 - 380 mg/dL

47
Q

 Elevation of Low Density Lipoproteins (LDL)
 Elevation of Triglycerides
 Associated with premature coronary disease
 Associated with peripheral vascular disease

A

hyperlipidemia

48
Q

What is the Normal C-Reactive Protein?

A

 1.0 - 3.0 mg/L

49
Q

What is the Normal Homocysteine: ?

A

 Normal range = 4.6-11.2 micromol/L

50
Q 
 High levels - linked to increased
incidence of thrombosis &amp;
cardiovascular disease
 High levels - linked to deficiencies of
B vitamins (B6, B12, B9-folic acid)
A

Normal Homocysteine

51
Q

Blood group O can give blood to?

A

AB, A, B, O

52
Q

Blood group O can receive blood from?

A

O

53
Q

Blood group B can give blood to?

A

B and AB

54
Q

Blood group B can receive blood from?

A

B and O

55
Q

Blood group A can give blood to?

A

A and AB

56
Q

Blood group A can receive blood from?

A

A and O

57
Q

Blood group AB can give blood to?

A

AB

58
Q

Blood group AB can receive blood from?

A

AB, A, B, O

59
Q 
 Advantages:
◦ Reduces cardiovascular disease risk factors
◦ Possible reduction in vessel disease
 Found in fish oil
 Fatty fish such as tuna &amp; salmon
A

fish oil, fatty acids

60
Q

 Complications:
◦ GI upset
◦ Drug interactions: blood thinners & some BP
meds

A

fish oil, fatty acids

61
Q

Found in plant sources: Examples: canola or nuts

A

Omega-6 Fatty Acids sources

62
Q

 Reduces the ability of blood to clot
 Similar to aspirin effects
 Caution & stop 1 week before any surgery

A

garlic

63
Q

 Herb - yellow pigment of turmeric
 One of most powerful anti-inflammatory agents in
nature
 Can lower cholesterol levels & inhibit platelet
aggregation

A

Curcumin

64
Q

 Use of may increase BP

 Includes cold medicines & nasal sprays

A

decongestants

65
Q

What are some nursing diagnosis for perfusion?

A 
 Activity Intolerance
 Cardiac output, decreased
 Fluid volume, deficient or excess
 Nutrition, imbalanced
More than body requirements
 Safety – Risk for Falls
 Pain, acute
 Tissue perfusion, ineffective
 Therapeutic regimen management,
ineffective

N160 exam 3 (7 decks)

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