Introduction to Perfusion Learning Activity

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Indiana University, Purdue University, Indianapolis *

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H371

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Medicine

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Feb 20, 2024

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docx

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Introduction to Perfusion Learning Activity Assessment Review Complete the table below describing the cause or meaning of each perfusion assessment and an example of a patient who may present with the abnormal finding. Abnormal What does it mean? Example of a patient Jugular venous distention Distended neck veins. There’s high right atrial pressure Patient with right sided heart failure Cyanosis Bluish discoloration of skin d/t poor circulation or inadequate oxygenation Patient with heart failure Heart Murmur Abnormal blood flow patterns. Turbulent sounds between normal heart sounds Patient with a heart valve disorder S1S2 High-pitched scratchy sound heard during S1 and/or S2 at the apex Patient with pericarditis Thready Pulse Weak and slowly rising pulse Patient with an aortic valve disease Irregular Pulse Heart skips a beat and out of regular rhythm. Regularly irregular or irregularly irregular skipped beats Patient with dysrhythmias Cap refill >3 sec Blanching of the nail bed >3 sec after release of pressure. Poor peripheral perfusion Patient who is dehydrated or with anemia Pitting edema Visible finger indentation after pressure. There’s an interruption of blood returning to the heart Patient with right sided heart failure Perfusion Components Complete the table below related to the assessment and interventions for each of the components of Perfusion. Give an example of a type of patient who may have impairment in each of the components.

Component Example of Patient Focused Assessment Finding Nursing Interventions Expected Outcome Increased Preload Patient with right sided heart failure. Fluid overload Edema, crackles, and JVD Daily weights Diuretics Decrease blood volume Decreased Preload Patient who’s severely dehydrated Lethargic, dark colored urine, dry mucous membranes Encourage fluids and electrolytes Patient becomes hydrated Increase blood volume Increased Afterload Patient with HTN Increased BP, SOB, headaches Beta blockers or ARBs (Vasodilators) Decrease resistance in the left ventricle BP return to normal appropriate range Decreased Afterload Patient with hypotension Decreased BP, orthostatic hypotension, fatigue, dizziness IV fluids Vasoconstrictors Increase resistance and pressure for heart to return to normal function Diagnostic Studies for Perfusion There are many medical and nursing assessment to determine the cause of a perfusion issue. Comment of these specific diagnostic test below and include nursing considerations. Diagnostic Studies Indication for test? What type of patient? Nursing Care and Consideration Cardiac biomarkers Released after there is injury to the cardiac muscle. Patient with suspected acute coronary syndrome Troponin is the biomarker used to diagnosis of ACS, c-reactive protein mark inflammation, cardiac natriuretic peptide markers increase highly indicative of heart failure Serum lipids Screening tool to help Elevated triglycerides and

understand the risk for cardiovascular disease. Patient with CAD cholesterol are risk factors associated with cardiovascular diseases Chest Xray Help diagnose heart failure and pulmonary edema Patient with cardiomyopathy Prior to this diagnostic test ask about frequency and hx of x- rays, and ask about pregnancy. Remove any jewelry or metal objects prior Stress test Evaluates how much a heart can take during stress Patient with CAD or having chest pain Monitor HR and RR during and evaluate the cardiac response to the stress Monitor EKG Echocardiogram Assess structures of the heart, ejection fraction of blood pumping from heart. Patient with a congenital heart defect Observe process of how the valves open and close. Monitor VS during to see how they change as the valves open and close b-type natriuretic peptide (BNP) Hormone secreted from cardiac cells Patient with heart failure High levels of BNP markers indicate heart failure, they can remain high for 1 month after cardiac surgery 12 lead EKG Analyze electrical impulses in the heart Patient who’s having arrythmia Place pt in supine or elevated HOB during placement Instruct to remain still during, so it doesn’t interfere with the reading TEE Provide detailed images of the heart and its internal structures. Patient with valvular heart disease Patient must be NPO prior, monitor O2 sat Cardiac Catherization/ angiography Visualize the arteries in the heart Patient with CAD Assess for allergies to iodine or shellfish, dye allergies, kidney function. Monitor BUN and Cr

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Introduction to Perfusion Learning Activity

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