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NUR 333: > Perfusion, Cardiovascular, and Peripheral Vascular > Flashcards

Perfusion, Cardiovascular, and Peripheral Vascular Flashcards

1
Q

perfusion

A

passage of fluid through the circulatory system or lymphatic system to an organ tissue
- bring o2 to tissues

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2
Q

Cardiac output

A

Volume of blood pumped by the heart in one min
- measured w invasive procedures, less accurate measures are VS

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3
Q

Stroke volume

A

Amount of blood ejected from the LV every time it pumps

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4
Q

Heart rate

A

Number of times heart beats/min

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5
Q

What can alter cardiac output

A

Any changes in HR, stroke volume or myocardial contractility
- can occur bc meds, disease processes, activity

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6
Q

Myocardial contractility

A

How hard heart contracts regardless of stretch factor

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7
Q

Ejection fraction

A

The percent of blood pumped out of the LV w each contraction
- normal is above 50%
- heart failure is less than 40%

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8
Q

Blood pressure

A

Force exerted by the blood against the bv walls
- needs to be adequate to maintain tissue perfusion during activity and rest
- 120/80

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9
Q

Pulse pressure

A

Difference between sbp and dbp
- normal: should be 1/3 of sbp

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10
Q

High pulse pressure caused by

A

Atherosclerosis
Excerise

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11
Q

Low pulse pressure

A

Severe heart failure
Hypovolemia

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12
Q

Pulsus alternans

A

Regular rhythm but strength varies w each beat
- possible explanation is heart failure

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13
Q

Cardiopulmonary resuscitation

A

CPR: performed when no pulse respirations
- CAB: circulate o2 blood to brain
* need to add more*

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14
Q

HTN

A

Pressure in ur arteries is high causing increased peripheral vascular resistance

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15
Q

Why is HTN bad

A

Causes adverse affects on arterial walls
- if left untreated it can cause dec blood flow and perfusion

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16
Q

Factors influencing bp

A

Age, stress, ethnicity, genetics, gender, daily variation, medications, activity, weight, smoking

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17
Q

Types of risk factors for bp

A

Modifiable:
- DM, elevated serum levels, excess Na, obesity, sedentary lifestyle, stress, tobacco, alcohol
Non modifiable:
- family history, race, ethnicity, increasing age, gender, chronic kidney disease, obstructive sleep apnea

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18
Q

Diagnosis is HTN

A

Avg or 2 or more readings in on at least subsequent visits that are above 120/80

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19
Q

HTN symptoms

A

Dizziness, headache, heart palpations, nose bleeds, SOB, anger, red face, visual problems, fatigue, insomnia, sore knee

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20
Q

Complications of HTN

A
  • cardiovascular disease
  • myocardial infarction
  • heart attack / failure
  • stroke
  • peripheral vascular disease
  • renal disease
  • retinal disease
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21
Q

Nursing actions for HTN

A
  • measure BP
  • lifestyle modifications
  • determine risk factors
  • educate
    Goal: prevent heart disease, stroke, renal disease
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22
Q

Education to teach pt for HTN

A
  • how to check BP
  • potential dangers
  • management options
  • lifestyle modifications
  • nutrition
  • exercise
  • stress management
  • drug therapy
  • when to seek care
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23
Q

Hypertensive crisis: when to seek immediate care

A
  • severe headaches, dyspnea, chest pain, dizziness, numbness, weakness, loss of vision, difficulty speaking, nosebleeds, severe anxiety, unresponsive
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24
Q

Diet often prescribed to HTN pt

A

DASH: dietary approach to stop HTN
- sometimes restrict Na intake

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25
Q

Hypotension

A

Low bp, usually sbp falls below 90

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26
Q

Causes of hypotension

A
  • dilation of arteries
  • loss of blood volume
  • failure of heart muscles to pump
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27
Q

Do we treat just number of bp

A

Yes and no, we address number but also pts baseline, if they have any symptoms

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28
Q

why do we care about hypotension

A

Need to make sure organs are getting the proper amount of o2 to function properly

29
Q

Symptoms of hypotension

A
  • skin: pallor, skin mottling, clamminess
  • dec perfusion to brain: lightheadedness, dizziness (syncope)
  • blurred vision
  • chest pain
  • inc HR
  • decreased urine output
  • nausea/ vomiting
30
Q

Treating hypotension

A

Treat cause
- Vasodilation
- loss of blood volume
- failure of heart muscle to pump

31
Q

Nursing considerations for hypotension

A
  • monitor VS
  • assess for symptoms
  • consider more Na in diet
  • inc fluids
  • compression fluids
  • medications
32
Q

Orthostatic hypotension

A

Decreased blood pressure if you stand up too fast
- creates fall risk
- blood can pool in areas like brain
- typically elderly ppl, immobile/ bed rest

33
Q

Diagnosing orthostatic hypotension

A

Sbp dec 20
Dbp decrease by 10
- measure bp supine, sitting, standing etc, w/in 3 mins of each other

34
Q

Nursing considerations for orthostatic hypotension

A
  • change positions slowly
  • don’t cross legs
  • early ambulation
  • isometric exercises
  • compression hose
  • avoid standing
  • risk for falls
35
Q

Hyperlipidemia

A

Too many lipids ( cholesterol and triglycerides) in the blood

36
Q

Cholesterol

A

Waxy fat like substances found in all cells of the body
- made in the liver

37
Q

Triglycerides

A

Most common fat in the body’
- made in body and ingest it

38
Q

Why do we care about hyperlipidemia

A

Can form hard deposits inside arteries
- can build up on artery walls causing it to narrow and became less elastic

39
Q

Hyperlipidemia diagnostic tests

A
  • test at age 20, then a 4-5 yr
  • age 40, assess risk for cardiovascular disease/stroke
  • must fast 9-12 hr before
40
Q

Hyperlipidemia nursing care

A
  • assess what they can change
  • be active
  • maintain healthy weight
  • limit smoking
  • dietary modifications
  • lipid lowering drug therapy
41
Q

Dietary modifications for Hyperlipidemia

A
  • reduce trans/sat fats
  • inc complex carbs and fibers
  • limit major sources of cholesterol, alcohol, simple sugars
  • eat fatty fish (salmon, herring, mackerel, sardines)
  • other foods high in omega 3 fas
42
Q

VTE

A

Venous thromboembolism
- obstruction of a bv by a blood clot that has become dislodged from another site and is moving in the circulation
- commonly starts in legs and travels to lungs

43
Q

Who is at risk for VTE

A

Ppl who have
- venous stasis
- hypercoagulability
- endothelial damage

44
Q

Venous stasis

A

Blood pools caused by
- obesity, pregnancy, post surgery, thickened blood

45
Q

Endothelial damage

A

Lining of vessel has injury from
- IV fluids
- drug abuse
- fracture, dislocation
- diabetes

46
Q

VTE s/s

A
  • localized redness, tenderness, swelling over vein sites
  • warmth, firmness in muscle
  • complaints of pain in calf w ambulation
  • unilateral
47
Q

Assessing for VTE

A

Palpation and visual
- often they are deep so must palpate in order for pt to feel tenderness

48
Q

VTE diagnosis

A

obtain history, physical assessment, vascular ultrasounds
- ultrasounds only reliable tool to detect (non invasive and will look dismally from area of concern)

49
Q

Why do we care about VTE

A

Pulmonary embolism: a dislodged clot that travels to lungs and blocks blood flow

50
Q

Nursing care for VTE

A
  • assess for symptoms
  • measure calf circumference
  • tenderness, phlebitis
  • early ambulation
  • TED hose, SCDs, calf pumping
51
Q

VTE treatment

A
  • prevention
  • anticoagulation
  • thromoblytic (lysis of thrombus)
  • IVC filter (vena cava device that strains blood to catch clots before getting to lungs
52
Q

diagnostics related to cardiovascular systems for fundamentals

A
  • complete blood count
  • fasting lipid panel
  • chest x ray
  • electrocardiography
53
Q

Hemoglobin and hematocrit counts

A

Hgb: Fe containing pigment of RBC that o2 adheres to
- f: 12-16, m: 14-18
Hct: % of total volume of blood that is made of RBC
- f: 37-47%, m: 42-52%

54
Q

ECG

A

Electrocardiogram: measures sinus rhythms

55
Q

Normal sinus rhythm

A

Originate in the SA node, follows normal sequence through conduction system
- P, PR, QRS, QT

56
Q

Telemetry

A

Monitors heart activity for an ongoing basis
- shows heart rhythm, continuous monitors but not as through as EKG

57
Q

electrode placement of telemetry

A

-snow over grass
- smoke over fire
- chocolate by my heart (5th intercostal space)
- snow and smoke (2nd intercostal space)
- grass and fire below rib cage

58
Q

Potential cardiac problems

A
  • unstable bp
  • activity intolerance
  • dec cardiac output
  • ineffective tissue perfusion
  • risk for dec tissue perfusion
  • fatigue
  • impaired gas exchange
  • ineffective airway clearance
  • fluid volume excess/deficit
59
Q

Nursing assessments for cardiac system

A
  • inspect/palpate
  • auscultation
  • obtain history
  • assess/monitor VS and O2
  • skin
  • LOC changes
  • peripheral pulses
  • calf tenderness
  • edema
  • JVD: jugular venous dissension
60
Q

Abnormal heart sounds

A
  • S3/4
  • murmurs: swishing, problem with valve
  • clicks : mechanical valve?
  • rubs: scratchy
61
Q

5 p’s for cardiac assessment

A

Pain
Pulse
Pallor
Paresthesia: numbness
Paralysis: movement

62
Q

Nursing implementations for cardiac

A
  • strict i and o
  • oxygen prn
  • telemetry
  • med admin
  • monitor labs
  • implement heart healthy diet
  • limit stress
  • prevent thrombus formation
63
Q

Nursing collab cardio

A
  • cardio pulm rehab
  • hcp
  • cardiologist
  • rt
  • code team
  • dietician
  • cardiac nurse navigators
  • support groups
  • social services/ case manager
64
Q

Pt teaching cardio

A
  • pt centered
  • set goals
  • no smoking
  • limit stress
  • control HTN, HLP, DM
  • nutrition
  • exercise
65
Q

Afterload

A

Amount of pressure the heart needs to exert to eject blood during ventricular contraction

66
Q

Infarction/necrosis

A

Obstruction of bloody supply to an organ/region and can cause tissue death
- typically cause by thrombus/embolus

67
Q

Ischemia

A

Blood flow is restricted restricting o2 to reach that area risking hypoxia

68
Q

Preload

A

Force that stretches the cardiac muscle prior to contraction

69
Q

stroke

A

Blood supply to the brain is cut off, preventing o2 from reaching the brain

NUR 333: (10 decks)

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