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perfusion
pathophysiology NUR 304
| Question | Answer |
|---|---|
| Define cardiac output (CO) | amount of blood ejection from the left ventricle over one minute |
| Why must the CO remain constant? | to achieve adequate perfusion to the body |
| What is the normal range for CO? | 4-8 liters/minute |
| How is CO calculated? | heart rate (HR) x stroke volume (SV) |
| What three factors influence stroke volume? | preload, afterload, and contractility |
| Explain preload | VOLUME. where the amount of blood returns to the right side of the heart. you can have too much or too little volume |
| What are some ways to increase preload? | increase fluid volume in the vascular space, elevate the leds, and placing the patient in the trendelenburg position. |
| What is the trendelenburg position? | The patient's legs are elevated above their head |
| What are some ways to decrease preload? | sitting the patient up with the legs down, and decreasing vascular volume |
| Explain afterload | RESISTANCE. the pressure in the aorta and peripheral arteries that the left ventricle has to work against to get blood out. how much resistance the ventricle has to overcome to pump blood out to the body |
| What are some ways to increase afterload? | making the patient's BP go up. LV will have more pressure to pump against. blood will be pumped out of the heart , causing CO to be diminshed |
| What are some ways to decrease afterload? | give the patient a vasodilator or an antihypertensive to decrease the pressure of the aorta. CO goes up |
| Define contractility | the heart's ability to "squeeze" volume out of the ventricle |
| Explain congestive heart failure (CHF) | aka left sided heart failure or right sided heart failure |
| What is left sided HF? | when the left ventricle fails and CO falls. the blood backs up into the LA & lungs causing pulmonary congestion |
| What are some causes of left sided HF? | coronary artery disease, long stand HTN, MIs, myocarditis or endocarditis, heart valve disorder, arrhythmias, pulmonary HTN, pulmonary embolism, hyperthyroidism, hypothyroidism, anemia, and kidney failure |
| What is the most common cause of left sided HF? | long standing hypertension |
| What are some CM of left sided HF? | crackles on auscultation, dyspnea, blood tinged frothy sputum, restlessness, S3, S4, orthopnea, nocturnal dyspnea. cool, pale skin |
| Define right sided HF | aka cor pulmonale. where the RV does not contract effectively. causes blood to back back up into the RA & peripheral circulation, which causes peripheral edema & engorgement of the kidneys & other organs like the liver |
| What are some causes of right sided HF? | left sided HF, HTN, age, infiltrations, infections that cause cardiac wall stiffness, heart valve disorders, lung disorders like COPD and PE |
| What are the most common causes of right sided HF? | left sided HF and lung disorders |
| What are some CM of right sided HF? | enlarged liver or spleen, epigastric tenderness, ascites edema, anorexia, nausea, JVD, weight gain, and nocturia |
| Define atherosclerosis | a condition where patchy deposits of fatty material develops in the walls of arteries, leading to reduced or blocked blood flow |
| What are some causes of atherosclerosis? | repeated injury to the artery wall, high cholesterol, infection due to bacteria or virus, and atheromas |
| What are some risk factors of atherosclerosis? | smoking, high cholesterol, high BP, diabetes mellitus, obesity, physical inactivity, high blood levels of homocysteine |
| What are some CM of atherosclerosis? | high BP, decreased peripheral pulses, angina, leg cramps, stroke, MIs, kidney failure, and malignant HTN |
| Define coronary artery disease (CAD) | a condition where the blood supply to the heart is partially or completely blocked |
| What is the patho of CAD? | atherosclerosis develops in the arteries, ateromas grow narrowing the arteries more, calcium accumulates, rupture of ateromas, more narrowing, thrombus forms, it detaches, ischemia happens, leading to angina and possible MI |
| What are some causes of CAD? | atherosclerosis, congenital defects, coronary artery spasm, dissecting aneurysm, infectious vasculitis, syphilis, high levels of c reactive |
| Define dissecting aneurysm | a bulging out of the vessel wall due to pressure. causes atherosclerotic plaque formation at the site. causes further weakening of the artery wall. a blood clot may form and dislodge, increasing the chance of a stroke. |
| Define infectious vasculitis | inflammation of the vessels contributes to growth of plaque in the arteries |
| What are some risk factors of CAD? | age, men, women after menopause, family hx, diets high in cholesterol and fats, HTN, smoking, diabetes mellitus, chronic kidney disease, abdominal obesity, sedentary lifestyle, and autoimmune disorders like RA |
| What are some CM of CAD? | MIs, agina, high BP, decreased peripheral pulses, nausea, vomiting, fainting or syncope, diaphoresis, SOB |
Created by:
keiondraharden
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