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Cardiac Perfusion

Cardiac Perfusion. Lewis, ch 32 Concept 22. The essential function of the CV and pulmonary systems is to provide a continuous supply of oxygenated blood to every cell in the body (see next slide).

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Cardiac Perfusion

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  1. Cardiac Perfusion Lewis, ch 32 Concept 22

  2. The essential function of the CV and pulmonary systems is to provide a continuous supply of oxygenated blood to every cell in the body (see next slide). • Changes in perfusion affect all human functions such as self-care, mobility, FV, respiration, tissue integrity, elimination, and comfort. About Perfusion

  3. Normal Blood Flow

  4. The heart muscle receives it’s blood supply from the coronary arteries during diastole (resting phase—between beats) • The quality of heart perfusion depends on the condition of the coronary arteries. • The quality of perfusion to the body depends on the condition of the heart. • Therefore, if the heart does not have good perfusion, the body won’t either. Perfusion and the Heart

  5. Heart Perfusion

  6. Cardiac output (SV x HR) • Preload, afterload, contractility • Peripheral vascular resistance • Blood volume • Blood viscosity • Artery elasticity • Oxygen saturation Factors Affecting Perfusion

  7. MI, valve disease, pacer • Hypertension • Diagnostic tests, hospitalizations, surgery • Rheumatic fever, strep • Cardiac meds • Risk factors—modifiable, nonmodifiable Assessment of Perfusion: History

  8. S/S—pain*, wt gain, swelling, palpitations, cough, dizziness, tingling • Problems with ADLs—DOE • Sleep problems—PND, pillows • Sexual concerns • Cultural influences • Problems with self image or relationships History cont’d

  9. P = Precipitating events • Q = Quality • R = Radiation • S = Severity • T = Timing Chest Pain Assessment*

  10. Blood pressure • Pulse rate, quality, and rhythm (see slide) • Heart sounds (see next slide) • Lung sounds • Neck veins • Breathing pattern Assessment of Perfusion: Physical Assessment

  11. Heart Sounds

  12. Pulse Sites

  13. Skin color and temperature • Ulcerations, edema • Color of mucous membranes, nail beds • Hair distribution on LEs • Nail texture & shape • Level of consciousness • Urine output Assessment cont’d

  14. Doppler ultrasound (duplex echo-730) • Electrocardiogram (729) • Echocardiograms (730, 734) • Stress test/Nuclear scan (730, 731) • CXR (729, 733), CT (731), MRI (731) • Cardiac catheterization (left) (732, 735) • Labs—troponin, CK-MB, lipids, BNP (728) Diagnostic Assessment of Cardiac Function

  15. Conduction System

  16. Relationship of ECG & Heart Sounds

  17. Confusion • Low blood pressure • Rapid or irregular heart rate • Shortness of breath • Decreased or absent pulses • Chest or extremity pain • Low urine output • Edema • Cold skin • Pale, gray, or blue skin color Manifestations of Poor Perfusion

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