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Care of Patients Across the Lifespan I-Nurs 3320 > Week 3 Perfusion and Dementia > Flashcards

Week 3 Perfusion and Dementia Flashcards

1
Q

What is perfusion?

A

How blood gets from tissues to organs and how they respond to that blood arriving there.

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2
Q

—– needs to be adequate to maintain health

A

perfusion

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3
Q

What is a sign of good healthy kidneys?

A

Good urine output

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4
Q

What is a sign of health going down hill?

A

Low urinary output (not enough blood flow to the kidneys)

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5
Q

—– —– is the amount of blood that leaves the left ventricle and is pumped through the body

A

stroke volume

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6
Q

What is related to heart rate and stroke volume?

A

Cardiac output

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7
Q

Formula for cardiac output?

A

heart rate x stroke volume

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8
Q

What condition is a sign of a weak heart pump>

A

Heart failure

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9
Q

What is a common medication used to make the heart pump more effectively (stronger)?

A

Digoxin

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10
Q

Action of digoxin?

A

strengthens heart’s “force of contraction”, and slows down the heart beat, allowing for more time for the heart to fill before pumping.

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11
Q

What does slowing the heart rate do for stroke volume?

A

It can increase it, because more blood will be in the heart before pumping.

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12
Q

What does running do to stroke volume?

A

Decreases stroke volume while heart rate is increased

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13
Q

What does the left ventricle act like for an athlete?

A

Stronger: injection fraction remains high because pump is so strong. It can keep stroke volume up

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14
Q

What might an active HR for athletes be?

A

110, because it still meets their physiological needs

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15
Q

Where may an athletes resting heart rate lie?

A

50- lower than a normal HR = healthy, athletic, conditioned, strong

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16
Q

What are the symptoms of HF with a heart rate around 40 bpm?

A

-fatigue and confusion= not good oxygenation/perfusion

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17
Q

Which autonomic system doesn’t work very well in someone with HF?

A

SNS

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18
Q

What three factors influence vascular resistance?

A

-blood vessel diameter
-elasticity
-blood viscosity

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19
Q

What does it mean when blood is spun and the hematocrit is high?

A

Ct. is dehydrated: less plasma and more of the fixed components (hematocrit)
If a ct. is dehydrated, there will be less volume, blood is thicker, and the heart has to work harder to push blood through.

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20
Q

What is the process of blood vessels when a pt. is dehydrated?

A

Vessels would dilate, then vasoconstrict.
-increase HR
-BP would bottom out (hypo)
-stroke volume would decrease

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21
Q

When it comes to stroke volume and HR, what is the correlation?

A

High stroke volume = slower heart rate
Fast heart rate = lower stroke volume

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22
Q

How is blood viscosity in our control?

A

Drink 1/2 body weight (lbs) in oz.

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23
Q

Ages effects on blood vessels:

A

-scarring
-less elasticity
-less resilient

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24
Q

When is cholesterol synthesized?

A

At night

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25
Q

Which type of medication prevents cholesterol formation?

A

statins

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26
Q

How does vascular sclerosis occur?

A

Cholesterol burrows into the vessel

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27
Q

Which vascular disorder is inevitable due to vessels losing flexibility as we age?

A

Arteriole sclerosis

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28
Q

Which system(s) control perfusion?

A

SNS & PNS

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29
Q

Which system are we supposed to spend most of our time?

A

PNS

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30
Q

What are symptoms of SNS activation?

A

High HR, low stroke volume, feeling hot/ sweaty, agitated, anxious

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31
Q

What is the best tactic for preventing endothelial injury?

A

Recognize when in SNS and calm down

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32
Q

Which nerve is effected when baring down to eliminate or void?

A

“vagal nerve”

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33
Q

What is the goal for our patient when they are ill?

A

Listen to their body and take it slow

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34
Q

Symptoms of hypotension?

A

dizzy, fainting, confusion, nauseous (decreased perfusion to organs), tachycardia, tachypnea (rapid breathing)

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35
Q

What are 4 causes of hypotension?

A
  1. medications
  2. standing up too quickly (orthostatic hypo)
  3. blood loss
  4. dehydration
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36
Q

What can excessive hypotension cause?

A

Shock

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37
Q

How many oxygen molecules can be picked up by a red blood cell?

A

4

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38
Q

Why might hypotension cause tachypnea (rapid breathing)?

A

heart rate increases, therefore, if blood cells are moving too quickly through the blood stream, not enough oxygen is being gathered by red blood cells = not enough perfusion to the body

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39
Q

When someone feels a palpitation (heart flutters) what should I do?

A

Compare radial pulse to apical pulse

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40
Q

where is the apical pulse found?

A

below the nipple, 5th intercostal space

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41
Q

What other condition can cause tachypnea due to lack of perfusion?

A

Anemia, not enough red blood cells

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42
Q

—– is an abnormal rhythm

A

Arrhythmia

43
Q

What does PVC stand for?

A

premature ventricular contraction

44
Q

What is a normal premature ventricular contraction range?

A

6 PVC per minute

45
Q

What does a premature ventricular contraction (PVC) of 7 or more cause?

A

-effects levels of consciousness
-“” ability to communicate

46
Q

—– interferes with ADL (activities of daily living) due to unmet needs by the heart.

A

Dysrhythmia

47
Q

Two classifications of palpitations:

A

Significant or insignificant

48
Q

Symptoms of significant heart palpitaiton?

A

Short of breath, dizzy, light-headed

49
Q

Symptom of non-significant heart palpitation?

A

Annoying

50
Q

What are significant palpitations a sign of?

A

Atrial fibrillation

51
Q

The atria conduction is supposed to be smooth, but with A-fib, it is turbulent. What do I worry about with A-fib ct?

A

Clots, stroke, MI

52
Q

What can cause turbulence and/or palpitations/discomfort.

A

Bad valves anywhere in the heart

53
Q

What heart sound can be heard with increased volumes of blood when one is pregnant?

A

S3 (fluid overload)

54
Q

What other condition may cause an S3 sound?

A

HF due to fluid retention

55
Q

two types of murmurs:

A

functional or problematic

56
Q

What causes a heart murmur?

A

Foramen ovale does not permanently close

57
Q

What does a murmur sound like?

A

Whoosh sound: “whoosh, lub dub”.

58
Q

When a murmur begins giving someone problems (which for many people it doesn’t), what procedure may be needed?

A

Open heart surgery.

59
Q

What is a functional murmur?

A

We know the problem is there and are monitoring.

60
Q

Prevention of a functional murmur becoming a problematic murmur involves what intervention?

A

Drugs that slow heart rate (beta blockers and digoxin)

61
Q

What is a symptom of taking medications that slows do HR?

A

HR doesn’t increase during exercise- struggle to establish exercise tolerance; prevents adequate perfusion for intense exercise needs

62
Q

What modifiable action can develop new arteries?

A

Exercising

63
Q

What is a concern when it comes to A-fib and it’s affect on the ventricles?

A

A-fib agitation may cause ventricular agitation (ventricular fibrillation), which could lead to cardiac arrest and death.

64
Q

What is documented when a heart has arrhythmia?

A

“Atypical heart sounds” Refer to PCP.

65
Q

—– —— is a condition that is presented by fingertips/hand that is blue.

A

Peripheral cyanosis

66
Q

What causes peripheral cyanosis?

A

vasoconstriction/ shock/ Raynaud’s disease

67
Q

A person with Raynaud’s disease needs to do what with their extremities?

A

Keep them warm

68
Q

What is Raynaud’s disease?

A

A condition that causes reduced blood flow to the fingers, toes, ears, lips, or nipples.

69
Q

What type of cyanosis is characterized by blue face or lips?

A

Central cyanosis (tissue hypoxia)

70
Q

What should be prevented with central cyanosis?

A

From the chest turning blue- poor pump = not enough o2 = HF; asthma; COPD; pneumonia

71
Q

Symptoms of CO2 poisoning:

A

pink/red skin

72
Q

What is the only test that can detect CO2 poisoning?

A

ABG (oximeter won’t pick it up)
*Urgent to treat

73
Q

What are our 4 roles in perfusion assessment?

A

-BP monitoring
-Pulse checks
-Skin color and temp
-Fluid management

74
Q

What are the three things we check for with pulse and document?

A

Rate, rhythm, strength

75
Q

What is the indication when assessing skin and finding pale, cool skin?

A

Poor perfusion.

76
Q

What is assessed when checking skin and temperature that relates to perfusion?

A

-capillary refill time
-color (cyanosis, pallor)
-temperature of skin
-dry or damp

77
Q

What are the 2 Ts that will require a blood infusion?

A

Tachycardia, Tachypneic (rapid shallow breathing)

78
Q

What needs to happen besides a blood infusion if ct. is tachypneic and has tachycardia?

A

Increase isotonic IV fluids. If we increase volume, the heart won’t have to pump so fast and perfusion will be restored!

79
Q

If vascular space is dehydrated, what type of fluids would help water go into the cells?

A

Hypotonic. Water flows to higher concentrations, so if it is hypotonic, it will flow into the cell.

80
Q

If there are too many fluids, and the ct. has a weak heart, what will occur?

A

Congestive HF.

81
Q

What is an intervention to be done when a ct. has too many fluids with a weak heart?

A

Give hypertonic fluids (will pull water from the cells and be excreted from the kidneys) OR diuretics (but can be hard on kidneys)

82
Q

—– —— is an indication for fluid resuscitation in pt. in a hypovolemic state?

A

fluid management

83
Q

What is assessed to manage fluids in a ct?

A

-fluid balance
-electrolyte levels

84
Q

A ct. is bleeding out and losing a lot of fluid. What can we give them to lower viscosity without having blood products?

A

IV fluids. “isotonic” = goes where I put them (the vascular space)

85
Q

When giving the heart enough fluids, what does this help?

A

Gives heart enough fluid to pump effectively so helps with B/P and perfusion.

86
Q

What happens to cells when a hypertonic solution is injected?

A

The cells lose water to the highly saturated water (from lower concentration [sat] to higher)

87
Q

Nursing intervention for someone who has hypertension with low volume?

A

Raise legs

88
Q

Why would I raise the legs of a client with hypertension with low volume?

A

increases the blood flow to the heart.

89
Q

What to veins have that actively pushes blood back towards the heart?

A

valves

90
Q

If there is edema in the extremities and legs are elevated, what does this do for vascular resistance?

A

It decreases it, and improves venous return.

91
Q

What positions compress blood vessels?

A

Crossing limbs

92
Q

What are the 3 most common conditions we face in the U.S (HINT: cardiac conditions)

A
  1. HT
  2. HF
  3. PVD (peripheral vascular disease)
93
Q

what is peripheral vascular disease?

A

When blood vessels narrow or become blocked. = reduced blood flow to all areas outside of the heart

94
Q

Elevated blood pressure- prehypertension = what range?

A

120-129 bp/ even if diastole is less than 80

95
Q

Hypertension stage 1 range:

A

130-139/ 80-89

96
Q

What are the very important educational goals when it comes to a ct. newly diagnosed with HT?

A

-medication adherence
-lifestyle changes (exercise, decreased sodium, stress, etc.)

97
Q

Symptoms of HF?

A

shortness of breath at rest; fluid restriction/change diet (PRN)

98
Q

two types of ulcers to prevent with foot care

A

venous and arterial

99
Q

Important Pt. Ed for peripheral vascular disease?

A

-smoking cessation
-exercise
-foot care (prevents ulcers)

100
Q

symptoms of peripheral vascular disease?

A

-skin red, swollen, and may dif. to find pulse due to edema.

101
Q

Interventions for peripheral vascular disease?

A

-raise legs
-compression stocking (first thing in the am) [as soon as legs go down, blood begins to accumulate].

102
Q
A
103
Q
A

Care of Patients Across the Lifespan I-Nurs 3320 (17 decks)

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