Circulation Flashcards by Nick Wrobel

What occurs when atherosclerosis occludes the coronary arteries?

Angina or Myocardial Infarction

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What is cardiac output (CO)?

The amount of blood pumped by the ventricles in 1 minute

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What is stroke volume (SV)?

The amount of blood ejected with each contraction

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What is the normal cardiac output?

4 - 8 L/min.

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What are some non-modifiable risk factors for Cardiovascular Disease?

Heredity (Race, Family History), Age, and Gender

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What are some modifiable risk factors for Cardiovascular Disease?

Elevated serum lipid level
Hypertension
Cigarette smoking
Diabetes
Obesity
Sedentary Lifestyle

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What are non-traditional risk factors for Cardiovascular Disease?

Metabolic Syndrome- central obesity, increased triglycerides, hypercholesterolemia, hypertension, and elevated fasting glucose
C-Reactive Protein at High Levels
Elevated Homocysteine Level- Homocysteine is an amino acid that has been shown to be increased in many people with atherosclerosis

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What are three major alterations in cardiovascular function?

Cardiac Output
Impaired Tissue Perfusion
Disorders that affect the composition or amount of blood available for transport of gases

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How does Myocardial Infarction decrease cardiac output?

If a large portion of the heart muscle is affected, particularly in the left ventricle, the affected muscle no longer contracts correctly.

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What are signs and symptoms of MI?

Chest pain: substernal and/or radiating to the left arm, jaw
Nausea
Shortness of Breath
Diaphoresis

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How does Heart Failure decrease cardiac output?

Irregular heartbeats:

Rapid beats doesn’t allow ventricles may not fill adequately between beats so stroke volume falls
Slow heart beat doesn’t have enough force to increase stroke volume to maintain cardiac output

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What can left-sided heart failure cause?

The vessels of the pulmonary system become congested, causing fluid to escape into the alveoli and interfere with gas exchange, which is pulmonary edema

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What are signs and symptoms of Heart Failure?

Pulmonary Congestion: adventitious lung sounds
Shortness of Breath
Dyspnea on Exertion
Increased Heart Rate
S3 Heart Sound
Increased Respiratory Rate
Nocturia
Orthopnea
Distended Neck Veins 
Pitting Edema

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What are some causes of impaired tissue perfusion?

Atherosclerosis is the most common

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What are signs of impaired peripheral arterial circulation in the legs and feet?

decreased peripheral pulse
pain or paresthesias
pale skin color
cool extremities
decreased hair distribution

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What are some examples of blood alterations that causes impaired cardiac output?

Inadequate RBCs
Low Hemoglobin
Abnormal Hemoglobin Structure (ex. Sickle Cell Anemia)

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What are some signs and symptoms of Anemia?

Chronic Fatigue
Pallor
Shortness of Breath
Hypotension

What is the benefit of auscultating for lung sounds when assessing cardiac function?

The nurse can assess for INCREASED PULMONARY VESSEL PRESSURE secondary to decreased cardiac output, as evidenced by adventitious lung sounds.

When assessing blood pressure in both arms, what should the nurse assess for and how far apart should the BP on both arms be?

Strength and Equality

10 mmHg of each other

Why are carotid arteries ausculated?

To detect BRUITS, which may indicate ATHEROSCLEROSIS

What is hemodynamics?

The study of forces or pressures involved in blood circulation. Evaluates fluid status and cardiovascular function.

What are some parameters measured directly in hemodynamic using catheters?

HR, Arterial Blood Pressure, and Venous Blood Pressure

What are some parameters in hemodynamics are calculated?

Stroke Volume

Cardiac Output

What are some NANDA diagnostic labels for circulation problems?

Decreased Cardiac Output
Risk for Peripheral
Neurovascular Dysfunction

What happens to the legs during immobility in terms of circulation?

Blood Pools in the veins of the lower extremities; Sluggish blood flow may cause VENOUS THROMBOSIS

What solution starts out as isotonic, but becomes ______, and how does this happen?

5% dextrose solution IN WATER; Hypotonic -Provides free water when dextrose is metabolized, expanding intracellular and extracellular fluid volumes interstitial space

What solution is used to treat metabolic alkalosis?

Lactated Ringer's

Which veins are commonly used for Venipuncture Sites for adults? Which ones for children?

Adults: Arms Children: Scalp and Dorsal Foot Veins

When performing IVs, select a vein that is...

- Easily palpated and Feels Soft and Full - Naturally splinted by bone - Large enough to allow adequate circulation around the catheter

When performing IV's Avoid using veins that are...

- In areas of flexion - Highly visible, because they tend to roll away from the needle - Damaged by previous use, phelbitis, infiltration, or sclerosis - Continually distended with blood, or knotted or tortuous - In surgically compromised or injured extremity

Which veins are common venipuncture sites?

Metacarpal, Basilic, and Cephalic vein

How are peripheral-short catheter used?

- Usually less than 1 week | - Comes in winged or non-winged

What are Over-The-Needle Catheters? What are they also called?

- Plastic catheter fits over the needle used to pierce the skin and vein wall - Once inserted into the vein, the needle is withdrawn and discarded leaving the catheter in place - Commonly used on adults - AKA Angiocatheters

What are Buterfly or Wing-up Catheters and how are they used?

- Plastic flaps attached to the shaft are held tightly to hold the needle securely during insertion and secured the tape once inserted - Frequently used for short-term therapy

What are Peripherally inserted Central Venous Catheter (PICC) and how are they used?

- Inserted in the basilic or cephalic vein just above or below the antecubital space of the right arm - Tip of the catheter rests in the superior vena cava - Frequently used for long-term IV access whe nthe client will be managing IV therapy at home

What are Central Venous Catheter Lines and how are they used?

- Catheter tip is in the central vein and in the superior vena cava - Greater ease of movement but more potential complications such as shortness of breath, hypotension, chest pain, cough, tachycardia

What are implantable venous access devices and what are they used for?

- Used for clients with chronic illness who require long-term IV therapy such as chemotherapy - Used to provide repeat access to the central venous system, avoiding trauma, and complications of multiple venipunctures - Surgical implantable ports are surgically placed into a small subcutaneous pocket under the skin near the clavicle - No part of the port is exposed

What are some reasons someone might use a sequential compression device and what does it do?

- Undergoing surgery - Immobilization - In critical care unit Promote Venous Return From the Legs to Prevent Thrombi and Edema

What are reasons Sequential Compression Devices NOT used for?

Arterial Insufficiency, Cellulitis, Infection of the Extremity, Active DVT, or Preexisting venous thrombosis

How do Sequential Compression Devices work?

They inflation and deflation stimulate the blood flow that results from walking and moves the blood back to the heart.

What problems do Sequential Compression Devices solve?

``` Deep Vein Thrombosis (DVT) Peripheral Edema (PE) ```