Perfusion Flashcards
HF alternative intervention
I and O, O2, BNP level, discharge info, assess respiratory lung function every 2-4 hrs
HF not improving
urine is 160 mL over 8 hrs and wheezing
Fetal HR 120 base and accell 135. The contract is 110-120
this is a normal document.
What does someone with bad perfusion look like in one word?
Crap (pale, diaphoretic, labored breathing)
What are some factors that impact perfusion?
- obesity
- trauma
- fevers
what does preload measure
Volume
What does afterload measure?
pressure
What are some signs of poor perfusion?
- confusion
- hypotension
- Dyspnea
- Decreased or absent pulse
- Pulmonary congestion
- Chest pain
- Low urine output
- Edema
- Cool,pale skin
- Cyanosis
What is the cardiac output formula?
CO= SV X HR
What is the threshold number for hypertension?
140/90 or higher
What are people with hypertension most at risk for?
CHD, HF, stroke, and renal failure
What factors can affect BP?
- temperature
- diet
- race
- gender
- age
- weight
- time of day
- position
- exercise
- emotional state
What are some factors that influence BP
- inflammatory mediators
- arteriosclerosis (hardening)
- Atherosclerosis (plaque)
When is someone in a hypertensive emergency?
BP> 180 systolic
>120 diastolic
What people are more likely to have HTN?
- middle-aged and older adults
- Blacks mores than whites and Hispanics
- In whites more males than females
- in blacks more females than men
What is one of the first signs of HTN?
Wake up with a headache but it goes away as the day goes on
What are some risk factors for HTN?
- family history
- age
- race
- mineral intake
- obesity
- insulin resistance
- excess alcohol consumption
- stress
What can someone do to their mineral intake to reduce their risk for HTN?
Reduce their sodium take and check the labels
What are some different diagnostics used to diagnose HTN?
- ECG
- Urinalysis (protein in the urine can indicate HTN
- Blood glucose
- Hematocrit
- Serum K+, creatinine, calcium
- Cholesterol and lipoprotein profile
What are some lifestyle modifications for HTN?
- diet
- reduced sodium intake
- maintain calcium and K+ intake
- Reduce saturated fats
- weight loss
- physical activity
- reduce/stop alcohol and smoking use
- stress reduction
If someone with HTN is on their BP meds, what should a nurse look for?
Orthostatic hypotension
If a patient with HTN is having falling problems what might be going on?
orthostatic hypotension from meds
How would you check for orthostatic hypotension?
wait 2 minutes between sitting and standing to check BP
How often should someone exercise to decrease their risk of HTN?
5 or more days/week
What are some interventions for HTN?
- promote health maintenance
- promote balanced nutrition
- maintain fluid volume
How would a nurse promote health maintenance?
- identify factors that contribute to HTN (are you using too much salt, or not exercising enough)
- Develop a realistic health maintenance pan
- help client, family identify strength, weaknesses in maintaining health
How would a nurse help promote balanced nutrition?
- Assess usual food intake
- determine realistic target weight
- refer to a dietitian
- recommend participation in an approved weight loss program
How would a nurse help a pt with HTN to maintain fluid volume?
- monitor I and O, daily weights (at the same time every day)
- monitor for peripheral edema (periorbital edema, sacral edema)
- Refer to a dietician
- Discuss adherence to the treatment plan
What are the signs of left-sided heart failure?
- Lungs (pulmonary congestion, orthopnea, tachypnea, exertional dyspnea)
- Blood tinged sputum (hemoptysis)
- Tachycardia
- fatigue
- circumoral cyanosis
What are the signs of Right-sided Heart failure?
- ascites, peripheral edema
- swelling
- jugular vein distention
- Enlarged liver and spleen
- weight gain
- dependent edema
- may be secondary to chronic pulmonary problems
- Might complain of shoes being too tight
What diagnostics are used for CHF?
- BNP (Increases when the heart muscle is stretched)
- Electrolytes
- BUN/Creatinine
- Liver function
- ABG’s
- CXR
- ECG
- Echocardiogram
What medications are used for CHF?
- ACE inhibitors (prils)
- ARBs (sartans)
- Beta-blockers (olos)
- Diuretics (thiazides and loops)
- Vasodilators
- Digitalis (digoxin)
- Antidysrhythmics
- GIve a little morphine to slow down their breathing
What is the nursing management of CHF?
- listen to apical pulse, assess HR and rhythm
- tachycardia frequently present, may see PAC’s or atrial fib
- May hear a gallop (S3 or S4)
- Monitor BP (maybe elevated)
- monitor urine output (only 150mL/8hrs= status is not improving)
- monitor neuro status
What are the interventions for CHF?
- administer O2
- Administer cardiac glycosides
- Encourage rest- cluster care
- Place in high fowler’s position
- Elevate legs
- Monitor labs
- meds
What is important for the nurse to do when giving an infant with CHF care?
Do cluster care so that the pt can sleep uninterrupted.
What are the indications for a Nonstress test?
- fetal growth restriction
- DM, pregestational and gestational diabetes treated w/ drugs
- Hypertensive disorder, chronic HTN, and preeclampsia
- decreased fetal movement
- post-term pregnancy
- multiple pregnancies
