Perfusion (1).pdf

Perfusion Level Z S. Wilson  Concept: Perfusion Definition: “The flow of blood through arteries and capillaries delivering nutrients and oxygen to cells.” (Giddens, 2022, p. 165). Alterations in perfusion may impair the circulation of blood through the tissues. Objectives...

Perfusion Level Z S. Wilson  Concept: Perfusion Definition: “The flow of blood through arteries and capillaries delivering nutrients and oxygen to cells.” (Giddens, 2022, p. 165). Alterations in perfusion may impair the circulation of blood through the tissues. Objectives 1. Principles of perfusion 2. Risk factors related to alterations in perfusion 3. Prevention strategies related to altered perfusion 4. Assessment and diagnostics 5. Clinical judgment related to alterations in perfusion Exemplars: hypertension, peripheral vascular disease, preeclampsia Pharmacology Alpha Adrenergic Adrenergic blockers (ex. Atenolol, metoprolol) Angiotensin Converting Enzyme Inhibitors (ex. Lisinopril) Angiotensin II Receptor Blockers (ex.Losartan, valsartan) Calcium Channel Blockers (ex. Diltiazem, Cardizem) Vasodilators (Nitrates) Diuretics (Loop, Potassium sparing, Thiazide) Magnesium Sulfate  Cardiac Output Cardiac Output = Heart Rate X Stroke Volume · Superior how does rate vena cava · Output? To lung To lung From lung From lung. Inferior vena cava a Load “ventricular contraction” ResistFance Pre- Load (V. contraction) Volume After-Load (V. contraction) Blood Volume SVR Stretch of the ventricle CVP/EDV measure pre-load > - Contractility Squeeze EF reflects contractility Starlings Law volume 4 Stretch ↑ Stroke volume  2. Risk factors related to alterations in perfusion ↑ Non-Modifiable Modifiable 1. Age 1. Hypertension 2. Smoking Naso constriction) nX 2. Genetics family Marfan syndrom/LAD/MI choles tool 3. Gender high 3. Diabetes 4. High cholesterol males ↑ Risk 4. ethnicity - African American Men 5. Obesity 6. Sedentary lifestyle cholestero, 7. Diet I fat , sodium , It , sugan 8. Chronic stress 9. Alcohol use (BIDfirst 12 is house 3. Prevention strategies related to impaired perfusion. Primary before Secondary early dx Tertiary preventing blood pressure complications educating analysis-preeclampsia E Stroke - diet & - - & exercise out management Meral a fal cessation Smoking amputatio a trial  4. Assessment and diagnostics HTN PVD Pre Eclampsia ⑪ HH ( family hx, lifestyle habits - any previous diagnosis or 20 weeks grotation treatments for HTN Physical assessment Capillary refill compare toes Fetal assessment Headaches and fingers HA, visual disturbances, Blurred vision Pain in extremities resolves with AMS (severe) Chest pain rest intermittent claudication Hyper reflexia clonus Murmurs/ rhythm changes (severe) Peripheral pulses Pulses, presence, symmetry LE Skin color Skin color, shiny,↓hair, temperature Weight sudden gain Weight cool wounds chronic arterial statis Edema rapid sudden Edema venous Edema (face hands feet) Diagnostics Ankle Brachial Index (ABI) ratio - D BP >=Thrombocytopimia 140/90 Blood pressure silent of BP ankle: BP arm 20. 9 platelets X indicates CBC