Perfusion powerpoint Flashcards by Natalia Farias

peripheral vascular disease deifinition and types?

to any conditions that result in altered blood flow outside the brain and heart.
chronic venous disease(CVD) and peripheral artery disease (PAD)

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chronic venous disease

Progressive disease within the wall of the vein or valves.
▪ Damaged, occluded, or congenitally altered veins
Blood flow is altered- reducing the
amount of blood returned to the heart

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Chronic venous disease consequences /

Blood pooling in the legs.
✓Increased venous pressure.
✓Vein distention and varicose veins.
✓ Leads to problems- venous stasis,
increased venous pressure, thrombus,
incompetent valves, and damage to
tissue (ulcer formation).

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CVD risk factors

▪ Smoking/ Tobacco
▪ Obesity
▪ Pregnancies
▪ Injury
▪ Leg Pain (Description, when it
started, improves or worsens?

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CVD manifestations

Dilated veins
* Edema that worsens when the legs
are dependent
* Brownish pigmentation
* Stasis dermatitis
* Lipodermatosclerosis
* Venous ulceration or
manifestations of healed venous
ulcerations.

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CVD implementation

Decrease venous pressure.
▪ Reduce pain and edema.
▪ Heal ulcerated skin areas.

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CVD conservative treatment

Compression therapy
▪ Meticulous foot care
▪ Leg exercises
▪ Elevation of lower extremities
▪ Weight reduction (if needed)

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CVD surgical treatment

▪ Vein Stripping (removal of diseased
vein)
▪ Sclerotherapy (rerouting blood to
healthier veins)
▪ Laser Ablation (sealing off of vein)

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CVD pharmacological treatment

Flavonoids(anti-inflammatory, diosmin[Daflon]),
Pentoxifylline(Trental)-hemorhedogic agent,
Acetylsalicylic acid (aspirin)-nonsteroidal anti-inflammatory,
Saponins-anti-inflammatory

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CVD client safety

Unsteady Gait- Assess the client for
the need of a mobility aid, such as a
cane or walker.
▪ Hemorrhage, phlebitis, and deep
vein thrombosis can also develop as
the disease progresses- Educate
client of signs and symptoms

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CVD nursing intervention

Leg Elevation- above their heart for 30 min 3 to 4 times a day.
▪ Injury Prevention.
▪ Prevention and management lower extremity ulcers.
▪ Smoking Cessation.
▪ Exercise- walking for 30 minutes a day.
▪ Avoid standing for long periods of time and crossing their legs when sitting.
▪ Healthy diet and weight maintenance.
▪ Compression Stocking Use- should apply them prior to getting out of bed.

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Peripheral artery disease (PAD)

Progressive disorder that affects blood
flow to the arteries in the lower
extremities
Damaged, inflamed, or occluded arteries

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PAD common cause

Common Cause: Atherosclerosis
▪ Plaque builds up in the artery walls
and causes decreased flow, blockage, or
spasms.
▪ Tissue hypoxia or anoxia results.
▪ Collateral circulation develops but not
usually enough.

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Factors that affect cardiac output

Vasoconstriction
Compliance of the arteries → stretch
Volume of blood entering the heart from the veins

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PAD risk factors

Smoking, diabetes, hypercholesteroLemia, hypertension, family history of cardiovascular disease

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Manifestation of PAD

↓ or absent pulses
Atrophy of lower extremity muscles
Cool skin
Elevated pallor and ↑ pain
Dependent redness and ↓ in pain
Pain upon palpation
Abnormal results: ankle brachial index, duplexultrasound.

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Treatment of PAD

Lifestyle modifications
Smoking cessation
Control hypertension
Weight / cholesterol maintenance
Blood glucose control
Exercise

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Invasive treatment of PAD

Ballon angioplasty →
Arterial stent
Bypass graft
Endarterectomy

Pharm treatment of PAD

(antiipemic)→ (antilipemic) → aggressive lipid management combined with dietary interventions
Antiplatelet → caspirin/ clopidrogreL → inhibits platelet aggregation, treats intermittent claudication
Pentoxifylline → trental → ↓ blood viscosity
Vasodilators → lisosorbidle mono/dinitrate → increases vessel size, ↑ oxygenation

The P wave

Electricity passing through the atrium
→ atrial contraction

The electrical pathway

SA node ( impulse begins)
Av node (captures the impulse and slows it)
Bundle of his
Bundle of branches → left bright
Purkinje fiber network

PR interval

Time it take to travel through the atrial, bundle of his, bundle branches, and purkunje fibers
Before ventricular contraction

QRS complex

Ventricular contraction

QRS interval

Contraction of both ventricles (systole)

ST segment

Time between systole (depolarization) and diastole (repolarization). Should be flat the same as the isoelectric line

T-wave

Time for ventricular repolArization

Q T interval

Entire electrical depolarization and depolarization of the ventricles

Described a normal sinus rhythm →NSR

P wave present PR intervals less than 0.20 and regular QRS complexes present and regular Other ECG elements present and regular HR between 60-100 bpm

Describe sinus bradycardia

P wave present PR intervals less than 0.20 and regular QRS complexes present and regular Other ECG elements present and regular HR ↓ 60 bpm

Bradycardia risk factors

High-endurance physical activity Myocardial infarction Sleep apnea ↑intercranial pressure Eating disorder↓ metabolic need Vagus nerve stimulation ( coughing and gagging, bowel movement straining) Infections Certain meds

Meds that cause bradycardia

* parasympathommetics (acetylcholine) Beta blockers (metoprolol) Digitalis glycosides (digoxin) Calcium channel blockers (diltiazem) Antiarrhythmics (amiodarone) Chemotherapy agents (thalidomide) Lithium

Symptoms of bradycardia

Dizziness Chest pain Syncope Mental status changes SOB ↓ hr

Nursing intervention of bradycardia

Stable: monitor clients ECG and vital signs Insert saline lock Anticipate administration of IV admin Unstable: gather supplies in preparation for urgent transcutaneous pacemakerplacement.

Client education bradycardia

Lifestyle changes Change body positions slowly How to check bp and pulse, normal or abnormal rates and when to notify provider.

Describe Sinus tachycardia

P waves present PR intervals less than 0.20 and regular QRS complexes present and regular Other ECG elements present and regular Hr ↑ 100 bpm

Symptoms of tachycardia

↑ rr Sob Chest pain Hypotension Mental status changes ↓ urine output Dehydration

Tachycardia risk factors

Fluid volume loss Fluid volume excess Pain, fever, mi, shock, or hyperthyroidism prescribed meds ( atropine, catecholamines, theophylline) Illicit drugs Caffeine/nicotine

Implementation Tachycardia

Stable: monitor patients ECG and vital signs - hemodynamic stability Vasovagal maneuvers Insert-a saline lock Unstable: monitor hr and bp Insert saline lock Anticipate admin of iv fluids or meds to lower hR Such as beta blockers

Describe arrhythmia

P Waves present Pr intervals less than 0.20 and irregular QRS complexes present but irregular Other ECG elements present and regular Hr varies

Hypertension types

PrimarY→ no specific cause, 90-95% of HTN adults Secondary→ specific, correctable cause- 5-10%, appears rapidly.

Hypertension risk factors

Modifiable: ↑ sodium intake Smoking use , obesity, alcohol use Microalbuminuria GFR < 60 Dyslipidemia Physical inactivity Non-modifiable: age, race (AA) diabetes, family hx

Organs affected with hypertension

Heart: ChF MI Brain: confusion, headache, stroke, memory loss Kidneys Eyes: retinopathy Reproductive: erectile dysfunction

Manifestations hypertension

Usually no symptoms other than ↑ bp Symptoms seen relatedto organ damage are seen late and are serious.