NR 283 Week 5 EDAPT; Perfusion and Clotting

EDAPT: PERFUSTION AND CLOTTING WK5 When perfusion is impaired, the outcome is very similar in all parts of the body. Tissues experience cellular death and a loss of function. Many things can impair perfusion, with one of the largest causes being a blood clot somewhere within the vascular system. What is the goal of perfusion? a. Flood the tissues with high amounts of oxygen and nutrients. The amount of blood pumped by the heart each minute? CENTRAL PERFUSION Volume of blood that flows from arteries to capillaries? TISSUE RISK FACTORS: MODIFIABLE Smoking Increased serum lipid Obesity Sedentary lifestyle NONFIABLE Age (more prone to problems) Gender (males are more prone) Genetics To get nutrients and oxygen into tissues, there are three important components, including fluid volume (transport), perfusion, and gas exchange. Once blood reaches and perfuses the tissue, it is up to gas exchange to get those nutrients and oxygen to the cells that need it. Perfusion ensures that every cell is reached. HIGH RISK: Clients with hyperlipidemia, diabetes, PVD, and arteriosclerosis are high risk for decreased central and tissue perfusion TYPES OF PERFUSIONS Tissue = skin / local areas Myocardial = heart Central = vital organs Cerebral = brain Arteries carry blood away from the heart to the aorta Arterioles = smallest branch of arteries leaded to capillaries (GAS AND NUTRIENT EXCHANGE) Capillaries = connects the arteriole to the venue 1828800461919formula called cardiac output to measure perfusion. Cardia output = Heart rate (per minute) x stroke volume (force of heart squeeze) formula called cardiac output to measure perfusion. Cardia output = Heart rate (per minute) x stroke volume (force of heart squeeze) Return to the heart via superior and inferior vena cava d. e. just looking at the skin color, capillary refill (in the fingernails), the color of skin around the lips, or even how alert someone is, CONDITIONS RELATED: Alert and awake Skin temp Blood pressure Skin color Recognize bad perfusion COMPLICATIONS INFARCTION = area of dead tissue HYPOXIA = low oxygen supply to the cells HYPOXEMIA = not enough oxygen in the blood NECROSIS = tissue death APOPTOSIS VS NECROSIS ISCHEMIA= poor perfusion to the tissue/organ RISK FACTORS atherosclerotic heart disease, cause blockages in the vascular system which leads to poor perfusion. Hypertension and dyslipidemia Vascular disease Poorly controlled diabetes mellitus - causes arterial inflammation Age - arteries and veins calcify, lifestyle behaviors - tobacco, secondhand smoke—and alcohol misuse causes arterial inflammation Genetic CAUSES MYOCARDIAL INFARCTION = TISSUE DEATH CVA = CELL DEATH SEPSIS = CELL DEATH TRAUMATIC BLOOD LOSS PVD As we age, we continue to build up blockages in our arteries. Because these blockages increase, sometimes medications that decrease the risk of clotting are started. Clots are more likely to occur in smaller arteries than in larger ones. The tissue experiences cellular death and a loss of function. PREVENTION PRIMARY diet exercise cessation of tobacco low dose acetylsalicylic acid (aspirin) DASH diet (Dietary Approaches to Stop Hypertension) weight management vii.hydration viii. SECONDARY Routine physicals glucose monitoring