Altered Perfusion Flashcards
(48 cards)
Forcing blood or other fluid to flow through a vessel and into the vascular bed tissue to provide oxygen
Perfusion
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
The inability to adequately oxygenate tissue at the capillary level
Altered Perfusion
Factors that could alter perfusion include:
▫️ventilation-perfusion mismatching
▫️impaired circulation
▫️inadequate cardiac output
▫️excessive perfusion demands
A condition of circulatory failure and impaired perfusion of vital organs- often equated with hypotension
Shock
Ineffective cardiac pumping
Cardiogenic shock
decreased blood volume
Hypovolemic shock
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
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
Occurs when the body is unable to maintain homeostasis with the compensations mechanisms
Decompensation
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
Hypertension when advanced, causes CNS changes;
▫️headache ▫️new-onset blurred vision ▫️confusion ▫️mental status changes ▫️fatigue ▫️nausea ▫️weakness ▫️vomiting
Risk factors of hypertension
▫️family history of hypertension ▫️diabetes mellitus ▫️excessive dietary sodium intake ▫️excessive alcohol intake ▫️gender ▫️aging ▫️obesity ▫️smoking ▫️sedentary lifestyle ▫️race
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 >
What are the causes of Altered Perfusion?
- Perfusion ventilation mismatch
- Impaired circulation
- Inadequate cardiac output
- Excessive perfusion demand
Ventilation perfusion mismatch would lead to:
- Respiratory disease
2. Pulmonary embolus
Impaired circulation would cause:
- Hemorrhage
- Obstruction or disruptions in blood flow
- Inadequate blood composition or volume
An inadequate cardiac output will lead to:
- Inadequate blood composition or volume
- Impaired ventricular pumping
- Structural defects
- Excessive peripheral vascular resistance
- Conduction defects
Excessive perfusion demands can cause:
- Prolonged exertion
- Metabolic exertion
- anemia
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
Application of the concepts of Altered Perfusion:
- Hypertension
- Shock
- Arterio-, arteriolo- and athero-sclerosis
- Aneurysms
- Varicose veins
- Deep Vein Thrombosis (DVT)
- MI (includes Angina)
- HF (LHF; RHF)
- Stroke
- DIC (disseminated intravascular coagulation)
degenerative loss of elasticity, thickening, hardening and calcification of the walls of arteries and arterioles
🔺cause of ⬆️ BP
Arterio And arteriolo-sclerosis
Presence of fatty plaques causing thickening inside the walls of large and medium arteries (aorta, iliac, coronary, carotid) particularly at points of bifurcation
Atherosclerosis
▫️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
