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Flashcards in Altered Perfusion Deck (48)
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1

Forcing blood or other fluid to flow through a vessel and into the vascular bed tissue to provide oxygen

Perfusion

2

What are the requirements for effective perfusion?

▫️adequate ventilation and diffusion
▫️intact pulmonary circulation
▫️adequate blood volume and components
▫️adequate cardiac output
▫️intact cardiac control center and receptors
▫️intact parasympathetic and sympathetic nervous systems
▫️intact cardiac circulation
▫️intact coronary circulation
▫️intact systemic circulation
▫️adequate tissue uptake of oxygen

3

The inability to adequately oxygenate tissue at the capillary level

Altered Perfusion

4

Factors that could alter perfusion include:

▫️ventilation-perfusion mismatching
▫️impaired circulation
▫️inadequate cardiac output
▫️excessive perfusion demands

5

A condition of circulatory failure and impaired perfusion of vital organs- often equated with hypotension

Shock

6

Ineffective cardiac pumping

Cardiogenic shock

7

decreased blood volume

Hypovolemic shock

8

Sources of impaired perfusion by massive systemic vasodilation:

▫️septic shock - infection
▫️neurogenic shock - lack of SNS from brain or spinal cord injury
▫️anaphylactic shock - large release of histamine

9

Shock manifestations

▫️tachycardia, tachypnea
▫️cool, clammy extremities with poor peripheral pulses
▫️decreased arterial blood pressure (a late sign indicative of decompensation)
▫️cyanosis and/or pallor
▫️restlessness, apprehension, decreased mental function
▫️poor urinary output

10

Occurs when the body is unable to maintain homeostasis with the compensations mechanisms

Decompensation

11

Hypertension- Manifestation

▫️often asymptomatic
▫️when advanced, causes CNS changes;
▫️CV changes
- pulmonary edema

▫️renal insufficiency
- poor urinary output
- problems with eliminating urinary waste
- hematuria
- proteinuria

12

Hypertension when advanced, causes CNS changes;

▫️headache
▫️new-onset blurred vision
▫️confusion
▫️mental status changes
▫️fatigue
▫️nausea
▫️weakness
▫️vomiting

13

Risk factors of hypertension

▫️family history of hypertension
▫️diabetes mellitus
▫️excessive dietary sodium intake
▫️excessive alcohol intake
▫️gender
▫️aging
▫️obesity
▫️smoking
▫️sedentary lifestyle
▫️race

14

Classification of High blood pressure in adults

systolic Diastolic
Stage 1 140-159 90-99
Stage 2 150-179 100-109
Stage 3 180 or > 110 or >

15

What are the causes of Altered Perfusion?

1. Perfusion ventilation mismatch
2. Impaired circulation
3. Inadequate cardiac output
4. Excessive perfusion demand

16

Ventilation perfusion mismatch would lead to:

1. Respiratory disease
2. Pulmonary embolus

17

Impaired circulation would cause:

1. Hemorrhage
2. Obstruction or disruptions in blood flow
3. Inadequate blood composition or volume

18

An inadequate cardiac output will lead to:

1. Inadequate blood composition or volume
2. Impaired ventricular pumping
3. Structural defects
4. Excessive peripheral vascular resistance
5. Conduction defects

19

Excessive perfusion demands can cause:

1. Prolonged exertion
2. Metabolic exertion
3. anemia

20

General manifestations of Altered perfusion:

▫️cyanosis, pain, pallor, coolness, edema, shortness of breath, impaired growth, tachycardia, tachypnea and fatigue
▫️hypotension and hypertension
▫️bleeding, bruising
▫️heart murmur

21

Application of the concepts of Altered Perfusion:

1. Hypertension
2. Shock
3. Arterio-, arteriolo- and athero-sclerosis
4. Aneurysms
5. Varicose veins
6. Deep Vein Thrombosis (DVT)
7. MI (includes Angina)
8. HF (LHF; RHF)
9. Stroke
10. DIC (disseminated intravascular coagulation)

22

degenerative loss of elasticity, thickening, hardening and calcification of the walls of arteries and arterioles
🔺cause of ⬆️ BP

Arterio And arteriolo-sclerosis

23

Presence of fatty plaques causing thickening inside the walls of large and medium arteries (aorta, iliac, coronary, carotid) particularly at points of bifurcation

Atherosclerosis

24

▫️localized dilation or out-pouching of a vessel wall
▫️typically caused by atherosclerosis, hypertension, congenital weakness in vessel walls, trauma, infections (e.g. syphilis)

Aneurysm

25

▫️distended, bulging and tortuous (winding) superficial or deep veins
▫️mostly found in legs but also in esophagus or rectum

Varicose veins

26

development of a thrombus in a vein - common cause of pulmonary embolisms

Thrombophlebitis or DVT

27

total occlusion of one or more coronary arteries resulting in ischemia and death of MI
- atherosclerosis is most common cause

MI

28

MI manifestation:

▫️gender variability
▫️chest pain or a crushing pressure, often radiating to the left arms, shoulder, or jaw
▫️fatigue, weakness, syncope, anxiety
▫️dizziness, shortness of breath
▫️sweating, pallor
▫️indigestion
▫️nausea, vomiting

29

reflects an inadequacy of heart pumping such that the heart fails to maintain the circulation of blood

HF

30

▫️congestion of peripheral tissues
⬇️
Dependent GI tract. Liver
Edema Congestion. Congestion
and as cites. ⬇️. ⬇️
anorexia, GI. signs related to
distress, wt loss. Impaired liver
function

Right Heart Failure