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NURS 470 > Perfusion > Flashcards

Perfusion Flashcards

1
Q

perfusion

A

the process of nutrient delivery of arterial blood to a capillary bed
(supplying an organ or tissue with oxygen and nutrients)

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2
Q

noninvasive assessment of perfusion

A

LOC
skin
urine output
color, BP, HR
capillary refill time

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3
Q

perfusion scanning methods

A

CT perfusion
MRI perfusion
nuclear medicine perfusion

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4
Q

cardiac output

A

the amount of volume/blood ejected/pumped from the heart in one minute
CO=HR*SV

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5
Q

normal CO

A

4-8L/min

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6
Q

normal cardiac index

A

2.4-4 L/min

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7
Q

stroke volume

A

volume of blood pumped with each heartbeat

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8
Q

normal SV

A

60-70mL with each ventricular contraction

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9
Q

impact of HR on CO

A

severe increase in HR decreases SV due to decreased filling time, and therefore decreased CO

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10
Q

four determinants of CO

A

heart rate
contractility
preload
afterload

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11
Q

preload

A

amount of blood in ventricle at end of diastole
the degree of stretch in myocardial fibers at the end of diastole
the end diastolic ventricular volume
a function of volume and ventricular compliance

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12
Q

factors affecting preload

A

volume: venous return, total blood volume, atrial kick
compliance: stiffness and thickness of ventricular wall

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13
Q

manifestations of decreased preload

A

tachycardia
decreased urine output
increased specific gravity
dry mucous membranes
tented skin
sunken eyes
orthostatic hypotension

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14
Q

increased preload

A

JVD
pedal edema
S3, S4
crackles
dyspnea
pink frothy sputum
ascities, hepatic engorgement

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15
Q

medications affecting preload

A

fluids
diuretics
venodilators: nitrates, morphine, ACE inhibitors

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16
Q

frank starling law of heart

A

increasing venous return, increases filling pressure of the ventricle will lead to increased force of contraction and stroke volume

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17
Q

afterload

A

ventricular pressure at the end of systole, the resistance against which the heart pumps blood

18
Q

factors affecting afterload

A

aortic impedance
blood viscosity
blood volume
vascular tone

19
Q

systemic vascular resistance

A

resistance to ejection from left side of heart
normal 800-1200

20
Q

pulmonary vascular resistance

A

resistance to ejection from right side of heart
normal 50-250

21
Q

increased afterload

A

pale, cool, clammy skin
HTN
non-healing wounds
thick, brittle nails
slow cap refill
decreased urine output

22
Q

decreased afterload

A

warm, flushed skin
increased CO
decreased BP

23
Q

contractility

A

the ability of a muscle to shorten when stimulated
the force of myocardial contraction
independent of preload & afterload
SNS and PNS innervation
measured as EF

24
Q

decreased contracility

A

hypotension
fatigue
SOB
dizziness
low urine output

25
Q

increased contractility

A

increased blood pressure

26
Q

indications for hemodynamic monitoring

A

alterations in cardiac output
alterations in fluid volume
alterations in tissue perfusion

27
Q

central venous pressure

A

volume/pressure on the right side of the heart
reflects filling pressures in the right ventricle
guides overall fluid balance

28
Q

noninvasive hemodynamic technologies

A

impedance cardiography
doppler ultrasound

29
Q

minimally hemodynamic technologies

A

CVP
arterial access line
MAP

30
Q

arterial line indications

A

monitoring blood pressure
frequent ABGs

31
Q

pulmonary artery catheter advantages

A

real-time data
measure a variety of hemodynamic parameters
able to rapidly assess pts response to interventions

32
Q

PA catheters disadvantages

A

infection
insertion complications
air emboli, exsanguination
balloon rupture
pulmonary artery rupture

33
Q

pulmonary artery wedge pressure

A

4-12mmHg
reflects left side preload

34
Q

pulmonary artery pressure

A

20-30/10s mmHg
blood pressure

35
Q

central venous pressure

A

2-6mmHg
reflects right sided preload

36
Q

pulmonary vascular resistance

A

50-250 dynes/sec/cm-5
reflects right sided afterload

37
Q

systemic vascular resistance

A

800-1200 dynes/sec/cm-5

38
Q

pulmonic valve stenosis/calcification

A

insidious process that happens over time
increased afterload on right ventricle

39
Q

pulmonary hypertension

A

increased afterload on right ventricle, which impacts right ventricular emptying

40
Q

interventions for elevated PA pressures

A

find cause/root of problem
reduction in preload (circulating volume)
decrease venous return to the right side
increase/improve contractility
meds: vasodilators, diuretics, Na and fluid restriction, valve replacement/repair

NURS 470 (28 decks)

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