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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
Normal for SV :
60 to 120 ml/beat
26
Stroke Volume (SV) x Heart Rate (HR)=?
Cardiac output
27
measured by invasive monitoring devices | • Pulmonary Artery Catheter
Cardiac output
28
What should be done after blood is drawn?
 Monitor venipuncture site for bleeding, hematoma, phlebitis, and/or infection.  Watch for lab results  Report significant abnormalities in results
29
 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
B-Type Natriuretic Peptide:
30
 Available IV  nesiritide (Natrecor)  Used to treat acute heart failure exacerbations  Causes arterial & venous dilation & diuresis  Results in decrease in afterload & preload
Synthetic BNP
31
Normal range – (PTT):
21-35 secs
32
◦ 1.5 - 2.5 times X baseline values (less than 50 increase heparin, over 100 decrease heparin) ◦ Usually 60-100 seconds (therapeutic=heparinized)
Therapeutic PTT (patient on heparin):
33
Normal range – (aPTT):
25-35 secs
34
Normal range - (PT) prothrombin time
10-13 sec
35
Therapeutic PT, prothrombin time (patient on warfarin) =
20-35 secs
36
Normal range- (INR) (not on anticoagulant)
<2.0
37
 Therapeutic INR – treatment of heart disease, venous thrombosis, pulmonary embolism
2.0-3.0
38
Therapeutic INR – patients with | mechanical heart valves or recurrent emboli
2.5 - 3.5
39
What are the normal hematocrit ranges for male and females?
 Male: 38 – 51% |  Female: 33 – 45%
40
What are the normal hemoglobin ranges for males and females?
 Male: 13.2 – 17.3 g/dL |  Female: 11.7 – 15.5 g/dL
41
What are the normal platelet ranges?
150,000 – 450,000/mm3
42
What are the normal WBC ranges?
4,500 – 11,100/mm3
43
Most influential electrolytes in perfusion:
Sodium, Potassium, Calcium, Magnesium
44
What are the normal iron ranges for males and females?
 50 to 170 mcg/dL in females |  65 to 175 mcg/dL in males
45
What are the normal ferritin ranges for males and females?
 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
What are the normal ranges for transferrin?
 200 - 380 mg/dL
47
 Elevation of Low Density Lipoproteins (LDL)  Elevation of Triglycerides  Associated with premature coronary disease  Associated with peripheral vascular disease
hyperlipidemia
48
What is the Normal C-Reactive Protein?
 1.0 - 3.0 mg/L
49
What is the Normal Homocysteine: ?
 Normal range = 4.6-11.2 micromol/L
50
```  High levels - linked to increased incidence of thrombosis & cardiovascular disease  High levels - linked to deficiencies of B vitamins (B6, B12, B9-folic acid) ```
Normal Homocysteine
51
Blood group O can give blood to?
AB, A, B, O
52
Blood group O can receive blood from?
O
53
Blood group B can give blood to?
B and AB
54
Blood group B can receive blood from?
B and O
55
Blood group A can give blood to?
A and AB
56
Blood group A can receive blood from?
A and O
57
Blood group AB can give blood to?
AB
58
Blood group AB can receive blood from?
AB, A, B, O
59
```  Advantages: ◦ Reduces cardiovascular disease risk factors ◦ Possible reduction in vessel disease  Found in fish oil  Fatty fish such as tuna & salmon ```
fish oil, fatty acids
60
 Complications: ◦ GI upset ◦ Drug interactions: blood thinners & some BP meds
fish oil, fatty acids
61
Found in plant sources: Examples: canola or nuts
Omega-6 Fatty Acids sources
62
 Reduces the ability of blood to clot  Similar to aspirin effects  Caution & stop 1 week before any surgery
garlic
63
 Herb - yellow pigment of turmeric  One of most powerful anti-inflammatory agents in nature  Can lower cholesterol levels & inhibit platelet aggregation
Curcumin
64
 Use of may increase BP |  Includes cold medicines & nasal sprays
decongestants
65
What are some nursing diagnosis for perfusion?
```  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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