Heart Failure and Perfusion Study Guide

Perfusion Concept Study Guide

• Perfusion: The circulation of oxygenated blood through tissues and organs, supplying oxygen and nutrients. Impaired perfusion can lead to organ damage.

Heart Failure (HF)

• Definition: A chronic condition where the heart cannot pump blood efficiently. Left-sided and right-sided HF are possible.
• Pathophysiology (Left-sided): Left ventricle fails, leading to pulmonary congestion (fluid in lungs), symptoms include shortness of breath, fatigue, and fluid retention.
• Pathophysiology (Right-sided): Right ventricle fails, causing fluid buildup in abdomen, legs, and feet. Symptoms include peripheral edema and jugular venous distention (JVD).
• Risk Factors: Coronary artery disease, hypertension, diabetes, obesity, smoking, family history.
• Signs & Symptoms: Dyspnea, fatigue, leg/ankle/abdominal swelling, orthopnea, tachycardia.
• Nursing Interventions: Monitor vital signs (esp. respiratory rate and oxygen saturation), administer medications (diuretics, ACE inhibitors, beta-blockers), lifestyle education (low-sodium diet, weight management).

Hypertension (HTN) and Anemia

• Hypertension (HTN): Consistently high blood pressure (systolic ≥130 mm Hg and/or diastolic ≥80 mm Hg).
• Pathophysiology (HTN): Damages blood vessel walls, increases workload on the heart, and can lead to heart failure, stroke, and kidney disease.
• Risk Factors (HTN): Age, family history, obesity, inactivity, alcohol intake, high-sodium diet, stress, smoking.
• Signs & Symptoms (HTN): Often asymptomatic, headaches, dizziness, blurry vision (severe cases), chest pain, shortness of breath (extreme cases).
• Nursing Interventions (HTN): Monitor blood pressure, administer antihypertensive medications, promote lifestyle changes (diet, exercise, stress reduction).
• Anemia: Reduced red blood cells (RBCs) or hemoglobin, impairing oxygen delivery to tissues.
• Pathophysiology (Anemia): Blood loss (e.g., bleeding), poor RBC production, or increased RBC destruction. The body compensates by increasing heart rate and breathing.
• Risk Factors (Anemia): Nutritional deficiencies (iron, B12, folate), chronic diseases (e.g., kidney disease, cancer), blood loss (ulcers, heavy periods), genetic conditions (sickle cell anemia)
• Signs & Symptoms (Anemia): Fatigue, pale skin/mucous membranes, shortness of breath on exertion, dizziness, tachycardia
• Nursing Interventions (Anemia): Administer supplements (iron, B12, folate), monitor hemoglobin/hematocrit, educate on iron-rich foods, encourage rest.

Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), and Peripheral Artery Disease (PAD)

• Deep Vein Thrombosis (DVT): Blood clot in a deep vein, often in the legs.

• Pathophysiology (DVT): Slowed blood flow (stasis), vessel injury, increased blood clotting (Virchow's triad). Untreated can lead to pulmonary embolism.

• Risk Factors (DVT): Prolonged immobility, hormonal therapy/pregnancy, smoking, obesity, older age, prior DVT/PE

• Signs & Symptoms (DVT): Swelling, redness, warmth, pain/tenderness (calf), potentially asymptomatic.

• Nursing Interventions (DVT): Elevate limb, warm compresses, administer anticoagulants (e.g., heparin, warfarin), encourage mobility and leg exercises

• Pulmonary Embolism (PE): A blood clot travels to the lungs, blocking blood flow and causing oxygen deprivation.

• Pathophysiology (PE): Impaired gas exchange, hypoxia, potentially life-threatening shock, or death if untreated.

• Risk Factors (PE): Recent surgery, trauma, prolonged immobility, DVT history, smoking, obesity, certain cancers

• Signs & Symptoms (PE): Sudden shortness of breath, chest pain, rapid breathing (tachypnea), bluish skin (cyanosis), coughing up blood (hemoptysis).

• Nursing Interventions (PE): Administer oxygen, anticoagulation or fibrinolytics, monitor for respiratory distress, educate on DVT prevention.

• Peripheral Artery Disease (PAD): Narrowing of peripheral arteries, reduces blood flow to limbs.

• Pathophysiology (PAD): Primarily caused by atherosclerosis, reduces oxygen to muscles/tissues in the limbs, leading to pain and potential damage.

• Risk Factors (PAD): Smoking, diabetes, hypertension, hyperlipidemia, older age

• Signs & Symptoms (PAD): Intermittent claudication (leg pain during exercise, relieved by rest), numbness/weakness in legs, cool/pale skin in affected limb, poorly healing wounds/ulcers

• Nursing Interventions (PAD): Encourage smoking cessation/exercise, medications to control blood pressure, cholesterol, and blood sugar. Promote proper foot care, monitor for infection.