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Flashcards in Perfusion Deck (65)
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1

What are the functions of the cardiovascular system?

 Promote perfusion of blood thru body
 Carry cellular wastes to excretory organs
 Promote return of blood to heart for oxygenation

2

What are the signs & symptoms assessed for perfusion?

◦ Chest pain / discomfort
◦ VS
◦ SOB / dyspnea / DOE
◦ Edema / weight gain
◦ Palpitations
◦ Fatigue / weakness
◦ Dizziness / syncope / fainting
◦ Auscultate heart sounds – S1 S2
◦ Carotid artery – palpate individually

3

What can be the causes of pain for perfusion?

◦ Acute Coronary Syndrome
◦ Inflammatory heart disorders
◦ Chest pain non-cardiac causes
◦ Leg pain

4

Average pressure
 Taking systolic &; diastolic pressures into consideration
 at least 65 mmHg = required for adequate
perfusion

Mean arterial pressure

5

 Systolic BP falls greater than10 mmHg on INSPIRATION
 Can indicate excessive fluid in the pericardial sac
 Restricts normal heart contraction – seen in pericarditis /endocarditis

Pulsus paradoxus

6

 Systolic BP – diastolic BP = ????
 Normal range is 30 to 40 mmHg
 Increasing pulse pressure = atherosclerosis
& exercise
 Decreasing pulse pressure = hemorrhage,
hypovolemia & shock.

pulse pressure

7

 Include measuring the BP & heart rate
 (HR) in 3 positions:
• 1st lying—supine
• 2nd sitting—dangling, and if the patient can tolerate it
• 3rd- standing

orthostatic blood pressure

8

◦ First heart sound
◦Closure of mitral & tricuspid valves

S1

9

◦ Second hearts sound
◦Closing of aortic & pulmonic valves

S2

10

 Ventricular gallop
 Occurs as blood enters noncompliant ventricles in early diastole
 Early sign of heart failure

S3

11

 Atrial gallop
 Occurs as blood enter atrium during atrial contraction
into nonconpliant ventricles at end of ventricular diastole

S4

12

 Summation gallop
 Sign of severe heart failure

S3 and S4

13

◦ Gentle blowing, swooshing sounds
◦ Turbulent blood flow through the valves

Murmurs

14

What are conditions resulting in murmurs?

◦Velocity of blood increases
◦Viscosity of blood decreases
◦ Structural defects in the valves
◦Unusual openings in chambers

15

Murmurs are usually described by their?

 Location
 Timing
 Grading
 Pitch
 Quality
 Radiation

16

*abnormal, high-pitched diastolic sounds heard during opening of an AV valve
*the sound is caused by a high pressure in the left atrium that abruptly displaces open a rigid valve leaflet
ex. mitral stenosis can cause this

opening snap

17

*stenosis of one of the semilunar valves creates a short, high-pitched sound in early systole, immediately after S1
*the result of the opening of a rigid and calcified aortic or pulmonic valve during ventricular contraction

systolic click

18

◦ Friction sound occurring with myocardial contraction
*a harsh, grating sound that can be heard in both systole and diastole
*caused by abrasion of the inflamed pericardial surfaces

Pericardial Friction Rub

19

Affected by alteration in any of the following:
preload, afterload, and/or contractility
◦ Defined as the amount of blood ejected by the left
ventricle per beat

stroke volume

20

◦ Stretch in myocardial muscle fibers before systole
◦ Determined by venous return to the heart &
elasticity of cardiac muscle fibers

preload

21

◦ Amount of resistance as blood ejected from
ventricles

afterload

22

Means the force at which the myocardial
muscule cells contract

contractility

23

◦ the percent of blood the left ventricle ejects with each
contraction
◦ Normal range is 55% to 65%.

ejection fraction

24

Normal for CO :

4 to 8 L/minute

25

Normal for SV :

60 to 120 ml/beat

26

Stroke Volume (SV) x Heart Rate (HR)=?

Cardiac output

27

measured by invasive monitoring devices
• Pulmonary Artery Catheter

Cardiac output

28

What should be done after blood is drawn?

 Monitor venipuncture site for bleeding,
hematoma, phlebitis, and/or infection.
 Watch for lab results
 Report significant abnormalities in results

29

 Neurohormone secreted from ventricles in
response to increased preload
 Serum marker for heart failure
 Results in elevated ventricular pressure
 Normal level should be < 100 pg/mL

B-Type Natriuretic Peptide:

30

 Available IV
 nesiritide (Natrecor)
 Used to treat acute heart failure exacerbations
 Causes arterial & venous dilation & diuresis
 Results in decrease in afterload & preload

Synthetic BNP