Tissue Perfusion Flashcards

1
Q

What is perfusion

A

The movement of blood

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2
Q

What is inadequate blood supply & perfusion

A

Ischemia, heart doesn’t get good blood supply

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3
Q

What is blood flow

A

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

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4
Q

Cardic output equation

A

Heart RatexStroke Rate OR
Mean Arterial Pressure/Resistance

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5
Q

Mean Arterial Pressure

A

COxR

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6
Q

What are the indicators of adequate perfusion

A

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

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7
Q

What is cyanosis

A

Blue coloration of the skin

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8
Q

What is pallor

A

No color of skin

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9
Q

What is JVD look like

A

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

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10
Q

What does clubbing look like

A

Nails are angled and have blue coloration

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11
Q

What is stroke volume

A

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

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12
Q

What is afterload

A

Force the ventricles must overcome to eject blood volume

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13
Q

What is the pulse

A

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

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14
Q

What factors can affect heart rate

A

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

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15
Q

What is arterial pressure

A

Measure of pressure of blood flow through arteries

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16
Q

Give an overall summary of blood pressure

A

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

17
Q

What is elevated blood pressure and hypertension

A

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

18
Q

How do you find the mean arterial pressure

A

Systolic blood pressure + diastolic blood pressure x 2/3

19
Q

What is resistance

A

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

20
Q

What does resistance depend on

A

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

21
Q

What are the medications for hypertension

A

HCTZ, losartan, captopril, metoprolol, nefedipine

22
Q

HCTZ

A

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

23
Q

Losartan

A

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

24
Q

Captopril

A

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

25
Metoprolol
Beta-blocker, decreases CO. Bradycardia s.e= dizziness, vertigo, fatigue, ED
26
Nifedipine
Calcium channel blocker vasodilator, decreases R Cannot eat grapefruit
27
What are some non-modifiable factors to hypertension and stroke
Age, gender, race, personal health history, family history( high cholesterol, early onset CAD)
28
What are modifiable risk factors
Quit smoking, eat healthy diet for normal BMI, start daily regiment of physical exercise, YOGA
29
What are secondary risk factors
Control high BP, decrease high blood cholesterol, decrease stress, abstain from or consume only small amounts of alcohol
30
What are some health screenings you can do
Blood pressure screenings, ECG, stress tes
31
What are some lifestyle modifications
Proper nutrition, exercise, keeping BP under 25, quit smoking, exercise (yoga or meditate)
32
Where can you assess the pulses
Temporal carotid apical bronchial radial femoral popliteal posterior tibial pedal
33
Where do you NOT measure blood pressure
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
34
What are the common errors and taking blood pressure
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)
35
What factors will increase blood pressure measurements
Caffeine, cigarette smoking, bladder distention, cold exposure, white lab coa
36
What factors will not make a difference in blood pressure measurements
taking blood pressure over clothing, on dominant arm or stethoscope under the cuff
37
Perfusion in older adults
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
38
Shock
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
39
Who has a higher risk of developing Hypersention & what works better for them
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