Tissue Perfusion

Question 1

What is perfusion

Answer 1

The movement of blood

Question 2

What is inadequate blood supply & perfusion

Answer 2

Ischemia, heart doesn’t get good blood supply

Question 3

What is blood flow

Answer 3

Cardiac output, the volume of blood that circulates through the system

Question 4

Cardic output equation

Answer 4

Heart RatexStroke Rate OR
Mean Arterial Pressure/Resistance

Question 5

Mean Arterial Pressure

Answer 5

COxR

Question 6

What are the indicators of adequate perfusion

Answer 6

Strong peripheral pulses
Blood pressure is within acceptable range
NO mental status deficits, cyanosis, pallor, dyspnea or edema
no JVD
Skin is warm and dry not cool and clammy
Urine output is 30 mm/hour

Question 7

What is cyanosis

Answer 7

Blue coloration of the skin

Question 8

What is pallor

Answer 8

No color of skin

Question 9

What is JVD look like

Answer 9

Popping out of the veins when laying down
Sign of heart failure

Question 10

What does clubbing look like

Answer 10

Nails are angled and have blue coloration

Question 11

What is stroke volume

Answer 11

The preload, how much blood is in the cavity of the heart

Question 12

What is afterload

Answer 12

Force the ventricles must overcome to eject blood volume

Question 13

What is the pulse

Answer 13

Represents a heart beat
peripheral pulse and apical pulse
strong=good perfusion
weak=bad perfusion

Question 14

What factors can affect heart rate

Answer 14

Age, older you are the higher it is
Gender, women have a higher one
Exercise
fever
medication
stress
position, lower heart rate laying down
hypovolemia
pathology

Question 15

What is arterial pressure

Answer 15

Measure of pressure of blood flow through arteries

Question 16

Give an overall summary of blood pressure

Answer 16

Recorded as a fraction:systolic, blood comes out, over diastolic, ventricles at rest,
typical in healthy adults: 120/80
but can vary considerably among individuals

Question 17

What is elevated blood pressure and hypertension

Answer 17

Elevated is 120 to 129/80
hypertension is anything from 130 to 140/80 to 90

Question 18

How do you find the mean arterial pressure

Answer 18

Systolic blood pressure + diastolic blood pressure x 2/3

Question 19

What is resistance

Answer 19

The opposition to blood flow due to friction between blood in the walls of blood vessels the higher
the resistance to lower the blood flow

Question 20

What does resistance depend on

Answer 20

Size of the blood vessel lumen, how vasodilator or vessel restricted it is
Blood viscosity
Total blood vessel length

Question 21

What are the medications for hypertension

Answer 21

HCTZ, losartan, captopril, metoprolol, nefedipine

Question 22

HCTZ

Answer 22

Diuretic decreases blood volume, orthostatic hypotension
Increased blood sugar
s.e= Dizziness, weakness, hypokelemia and ED

Question 23

Losartan

Answer 23

Vasodilator, decreases R
s.e= dizziness, headaches, nausea, vomitting, diarrea

Question 24

Captopril

Answer 24

ACE inhibitor vasodilator, decreases R
s.e= dizziness, salty taste, cough, fast heartbeat, tiredness

Question 25

Metoprolol

Answer 25

Beta-blocker, decreases CO. Bradycardia
s.e= dizziness, vertigo, fatigue, ED

Question 26

Nifedipine

Answer 26

Calcium channel blocker vasodilator, decreases R
Cannot eat grapefruit

Question 27

What are some non-modifiable factors to hypertension and stroke

Answer 27

Age, gender, race, personal health history, family history( high cholesterol, early onset CAD)

Question 28

What are modifiable risk factors

Answer 28

Quit smoking, eat healthy diet for normal BMI, start daily regiment of physical exercise, YOGA

Question 29

What are secondary risk factors

Answer 29

Control high BP, decrease high blood cholesterol, decrease stress, abstain from or consume only small amounts of alcohol

Question 30

What are some health screenings you can do

Answer 30

Blood pressure screenings, ECG, stress tes

Question 31

What are some lifestyle modifications

Answer 31

Proper nutrition, exercise, keeping BP under 25, quit smoking, exercise (yoga or meditate)

Question 32

Where can you assess the pulses

Answer 32

Temporal
carotid
apical
bronchial
radial
femoral
popliteal
posterior tibial
pedal

Question 33

Where do you NOT measure blood pressure

Answer 33

Shoulder, arm or hand injury
Cast or bulky bandage on any part of the limb
Where axila lymph nodes on that side have been removed
IV infusions in that limb

Question 34

What are the common errors and taking blood pressure

Answer 34

Haste (doing it quickly and letting go of the needle quickly not being able to see the real measurement and making up a number)
Sub conscience bias(may hear value consistent with the expectation)

Question 35

What factors will increase blood pressure measurements

Answer 35

Caffeine, cigarette smoking, bladder distention, cold exposure, white lab coa

Question 36

What factors will not make a difference in blood pressure measurements

Answer 36

taking blood pressure over clothing, on dominant arm or stethoscope under the cuff

Question 37

Perfusion in older adults

Answer 37

Valves become stiff, myocardial hypertrophy, slight decline in CO, decrease elasticity, elevated BP, lower arterial 02 Tonchin decreased ability to concentrate urine a.k.a. dehydration

Question 38

Shock

Answer 38

In adequate perfusion results in failure of the CV system to meet the metabolic demands of body cells
type of shocks are: hypovolemic, cardiogenic, vascular, obstructive

Question 39

Who has a higher risk of developing Hypersention & what works better for them

Answer 39

40% greater risk are African Americans
Least effective: Beta-blockers like metoprolol and ACE inhibitor like Captopril
Best: HCTZ and channel calcium blockers like diltiazem or nifedipine or Losartan