Circulation & Perfusion Flashcards

1
Q

What 3 types of vessels makes up the vascular system?

A

Arteries, veins, and capillaries

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2
Q

All vessels are lined with what?

A

Smooth endothelial layer

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3
Q

What % of oxygen is bound to hemoglobin?

A

97%

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4
Q

T/F. The coronary arteries are the only arteries that fill during diastole ?

A

True

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5
Q

The ANS regulates cardiovascular function through its influence on what 2 things?

A

The heart and vascular system

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6
Q

What are baroreceptors?

A

Located in the walls of the heart and blood vessels. They sense blood pressure changes. If BP is low they will send signals to brain to stimulate SNS and increase HR and induce vasoconstriction.

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7
Q

What kind of receptors does the vascular system have to sense changes in blood pH, oxygen, and CO2?

A

Chemoreceptors

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8
Q

What is MAP?

A

Mean arterial pressure calculation that checks whether there’s enough blood flow, resistance, and pressure to supply blood to the major organs.

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9
Q

Most people need a MAP of how many mmHg to ensure enough blood flow to vital organs?

A

At least 60mmHg or greater

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10
Q

What is considered a high MAP meaning that there is a lot of pressure in the arteries?

A

Anything over 100mmHg

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11
Q

Why is a MAP under 60mmHg bad?

A

Because blood may not be reaching organs

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12
Q

What is pre load ?

Think volume

A

Pressure of blood entering the heart. Amount of blood in the ventricles at the end of diastole.

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13
Q

What is after load ?

Think resistance

A

Pressure of blood leaving the heart. So increase vascular resistance will increase after load.

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14
Q

What is stroke volume?

A

Amount of blood ejected with each ventricular contraction

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15
Q

What 3 factors affect stroke volume?

A

Contractility, pre load, and after load.

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16
Q

How is cardiac output calculated?

A

HR x SV

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17
Q

What is a normal cardiac output ?

A

4-7 L/min

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18
Q

What is the appropriate diagnosis when the heart is unable to pump adequate amounts of blood to meet metabolic demands of the body?

A

Decreased cardiac output

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19
Q

When does cardiac output increase?

A

With exercise or activity

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20
Q

When does cardiac output decrease?

A

Times of rest

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21
Q

What is a normal EF?

A

More than 55%

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22
Q

What is EF?

A

Amount of blood that is pumped out of the left ventricle with each contraction

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23
Q

Why do HF patients have a EF less than 40%?

A

Msl of left ventricle is not pumping as well

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24
Q

What 6 factors influence cardiac function?

A

Developmental stage, environment, lifestyle, substance abuse, medications, and patho physiological conditions.

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25
Q

Why does cardiac efficiency gradually decline in older adults?

A

Thicker and more rigid valves, decreased myocardial strength, lower exercise tolerance, more prone to orthostatic hypotension.

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26
Q

At what intervals do we take orthostatic vital signs?

A

1-3 minutes after each change of position

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27
Q

What neurotransmitter is released from the SNS with stress?

A

Catecholamines

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28
Q

How does heat influence cardiac output?

A

Causes vasodilation which increases cardiac output and oxygenation. Also increases metabolism.

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29
Q

How does cold influence cardiac output?

A

Causes vasoconstriction, slows HR, prolonged exposure can cause frostbite, loss of hypothalamic temp regulation and death

30
Q

Tobacco does what to blood vessels?

A

Causes vasoconstriction creating a problem with afterload.

31
Q

What are the 2 most common CV depressants?

A

Beta-adrenergic blocking agents and calcium channel blocking agents

32
Q

How are CV depressants used therapeutically?

A

To slow HR or reduce the force of myocardial contraction

33
Q

What negative effects can CV depressants have?

A

Reduce cardiac output and impair tissue oxygenation

34
Q

What causes L sided HF?

A

When L ventricle does not pump sufficient amounts of blood to body organs and tissues. Fluid can back up into lungs and cause respiratory issues.

35
Q

What causes R sided heart failure?

A

When R ventricle does not pump sufficient amount of blood to the lungs and it backs up into the venous system

36
Q

What CV disease is considered the silent disease?

A

HTN

37
Q

How do dysrhythmias influence cardiac function?

A

Can lower cardiac output, decrease tissue oxygenation, and increase the risk for stroke.

38
Q

Which valves are most commonly affected by heart valve abnormalities?

A

Mitral and aortic valves

39
Q

What are 2 occurrences where oxygen transport is impaired?

A

Anemia and carbon monoxide poisoning

40
Q

What is capnography?

A

Non invasive and provides breath to breath ventilation. Measures CO2 in inhaled and exhaled air.

41
Q

What are 3 test to measure blood oxygenation?

A

Pulse ox, capnography, and ABGs

42
Q

What labs should be routinely checked for CV risk assessment?

A

Cholesterol, lipid panel, CRP, and glucose

43
Q

What is a thrombus?

A

Stationary clot adhering to the wall of a vessel

44
Q

What is an embolus?

A

Clot that travels into the bloodstream

45
Q

What is the intra cellular space?

A

Inside the cells

46
Q

What makes up the ECF?

A

Interstitial fluid, intravascular fluid, transcellular fluid.

47
Q

What is the interstitial fluid?

A

Space between the cells. Fluid in this space is called edema.

48
Q

What is the intravascular fluid?

A

Plasma within the blood

49
Q

What is the transcellular fluid?

A

Special fluids like CSF, synovial, digestive juices, pleural, and peritoneal fluid.

50
Q

It is recommended for women to drink how much fluid?

A

2,700 mL/day

51
Q

It is recommended for men to drink how much fluid?

A

3,500mL/day

52
Q

Which hormones are involved in fluid and electrolyte balance?

A

ADH, RAAS, thyroid, ANP, BNP, and CNP

53
Q

K is important for what function?

A

Muscle contraction and cardiac conduction

54
Q

What causes hypomagnesemia in people who have high alcohol intake?

A

Alcohol withdrawal can cause electrolyte shifts as glucose enters the cell

55
Q

What are signs of fluid overload?

A

Elevated BP, bounding pulse, increased and or shallow respirations, JVD, pale, cool skin, edema, lung crackles, and ascites

56
Q

T/F . It is better to prevent imbalances than to treat them?

A

T

57
Q

What is osmolality (or tonicity) ?

A

The concentration of solutes creating pressure in body fluid

58
Q

What is the MAP equation?

A

SBP + (2x DBP) / 3

59
Q

To promote peripheral arterial circulation what should we teach the client and family?

A

Tobacco cessation, foot care, regular exercise, proper positioning, medication, and warmth.

60
Q

What can a BNP lab value tell us?

A

Released by the atria in response to stretch. Indicates hypervolemia.

Helps determine presence of heart failure with fluid excess and to distinguish from pulmonary edema

61
Q

ANP, BNP, and CNP are hormones produced where?

A

By heart cells

62
Q

How does thyroid hormone influence cardiac output?

A

Increase in thyroid hormone causes an increase in cardiac output

63
Q

What are common sites for nitro ointment?

A

Chest or deltoid

64
Q

How long can a nitro patch be worn for?

A

12-24 hours per day

65
Q

What does it mean to give the patient a “nitro holiday”?

A

Making sure to give them a break with usage so that tolerance does not build up

66
Q

Why do we rotate application sites of nitro patch?

A

To avoid skin irritation

67
Q

T/F. Always remove a nitro patch prior to defibrillation or cardioversion to prevent burns.

A

True

68
Q

Is nitro a vasodilator or constrictor?

A

Vasodilator

69
Q

What are the two purposes of nitro?

A

To alleviate angina and in some cases reduce blood pressure

70
Q

Do high doses of nitro affect pre load or after load?

A

After load