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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Dec 6, 2023

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docx

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3

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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 A patient with right-sided heart failure. Cyanosis Bluish discoloration of skin due to poor circulation or inadequate oxygenation. A pt. may have reduced blood flow from HF. Heart Murmur Turbulent sounds occurring between normal heart sounds. Pt 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, slowly rising pulse easily obliterated by pressure Pt with an aortic valve disease Irregular Pulse Regularly irregular or irregularly irregular skipped beats Pt with dysrhythmias Cap refill >3 sec Blanching of nail bed for >3 sec after release of pressure Pt with reduced arterial capillary perfusion Pitting edema Visible finger indentation after application of firm pressure. Patient with cardio disease or hypothyroidism. 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 Pt with hypovolemic shock Checking BP/HR Give ace inhibitors. Patient will maintain good perfusion.
Decreased Preload Patients with congestive heart failure Checking BP/HR Give the patient diuretics and nitroglycerin. Increased urine output, decrease in peripheral edema, BP/HR within normal limits Increased Afterload Patients with aortic stenosis Check BP/HR Give vasodilators. Lower BP Decreased Afterload Pt with arrhythmias. Check BP/HR Give vasodilators. Lower BP 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 They are released after injury to cardiac muscle. C-reactive protein mar inflammation. Its increase can mean HF. Monitor patient temp and peripheral pulses frequency. Serum lipids Triglycerides fatty acid elevation is associated with cardiovascular diseases. Cholesterol is also a risk factor associated with this. Take statin meds and for patient to eat low fat diet and include diet and exercise. Chest Xray Can show cardiac size and shape as well as fluid around the heart and lungs and changes in the aorta. Tell the pt. to hold their breath during the exposure and no food and restrict medications. Stress test This test shows if a patient has angina and ACS. Instruct the patient to fast and restrict fluids. Echocardiogram This assesses the structures in Avoid food and drink for a few
the heart as well as the pumping of the heart with patient who have heart failure. hours before the test. b-type natriuretic peptide (BNP) Seen in patients with HF. BNP goes up when the heart cannot pump the way it should. Do an assessment prior to the test. 12 lead EKG Leads can analyze the electrical impulses in the heart. A change in this can indicate that the patient has angina and ACS. Ensure the position of the electrodes are in the correct place and record the accurate data. TEE Used to assess the valves and endocarditis. IT can also detect clots in heart. Explain the procedure, get pt. consent, and check the IV line. Cardiac Catherization/ angiography This is used to establish cardio toxicity of drugs as well as establishing viable tissue and non-viable. Watch BUN and CR due to the dye load and check for shellfish allergies or iodine.
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