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CCBC Nursing 160- Exam 3 Prep Latest Update @ 2024
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CCBC Nursing 160- Exam 3 PrepLatest Update @ 2024
What is the term used to describe the exchange of blood, gases, and fluids between the
vessels, tissues, and organ systems? - Answer Perfusion.
What is the primary purpose of the cardiovascular system? - Answer Primary purpose is
to pump blood and distribute it to all areas of the body.
*When problems exist with the cardiovascular system it can lead to death.*
How does the cardiovascular system function? - Answer It promotes the perfusion of
blood through the body, carries cellular wastes to excretory organs, and promotes the
return of blood to the heart for oxygenation.
What is the first thing the nurse should do when a patient comes in with possible
perfusion issues? - Answer An ASSESSMENT!
What kind of questions should the nurse make sure to ask the patient in regards to
possible perfusion problems? - Answer 1. *Health History:*
- History of present illness: What is their chief complaint and is it urgent or not? For
example, chest pain is ALWAYS urgent.
- Past medical history: Any comorbidities, such as diabetes or PVD? Have they had any
childhood infections that could have damaged the heart?
- Family history of perfusion problems?
- Functional health patterns: how is their nutrition? How well do they sleep? How active
are they? Any problems with sexuality or stress? What are their personal habits?
- ADL's: Any DOE? Are they sedentary or active? Do they have any edema or fatigue?
When did it start? How long has it been going on? What brings it on and what relieves it?
- Height and weight: Elevated BMI can be an indicator or precursor to CVD.
- Medications
In regards to functional health patterns, what are some signs and symptoms that could
be indicative of possible CVD? - Answer 1. *Nutrition*
- weight loss or gain: more than 2 pounds in a day or 5 pounds in a week? (Even a measly
5 pounds can increase the demands on cardiac function).
,- special diets: for example, if they do have perfusion issues they should be restricting
sodium and eating low fat.
2. *Sleep*
- sleep apnea: causes snoring and fatigue and is often associated with cardiovascular
problems due to a perfusion source. Ex, they may be snoring because of an airway
obstruction that is decreasing their perfusion.
- dyspnea
- fatigue
- orthopnea
3. *Sexual Acitivity*
- difficulty or frequency: if it's not being perfused then it won't work.
- fertility issues
4. *Activity*
- sedentary or active?
- *activity intolerance is a BIG indicator of perfusion issues!* Are they SOB or
experiencing DOE?
5. *Personal Habits*
- caffeine use
- alcohol use
- tobacco use
- illicit drug use: patient may not tell you but if they are their vessels are usually already
sclerotic and they may have cellulitis.
6. *Stress*
- increased coping response -->increases HR and BP
What are some non-modifiable (cannot be changed) risk factors related to perfusion
issues? - Answer 1. Age
2. Family history (genetics)
3. Gender
4. Race
,What are some modifiable risk factors related to perfusion issues? - Answer 1. Smoking
2. Obesity
3. Dyslipidemia
4. Stress
5. Sedentary lifestyle
6. Modifiable medications: DM, HTN, Metabolic Syndrome (improvement of the control of
the diseases can help decrease the possibility of damage to the vessels)
What kind of medications is it important to ask the patient about when assessing
whether or not a perfusion issue is present? - Answer ALL OF THEM!
1. Current list of medications.
2. Any OTC medications such as: decongestants (these are stimulants and can affect
BP, ex: Claritin), cold meds, nasal sprays, vitamins, and laxatives.
3. Any CAM such as: garlic, fish oil (oils change the metabolic rate of other pills), omega
fatty acids, and even curcumin/curry (these have a strong systemic anti-inflammatory
effect).
What are some notable signs and symptoms related to perfusion issues? - Answer 1.
*CHEST PAIN/DISCOMFORT IS ALWAYS AN EMERGENCY AND REQUIRES IMMEDIATE
ASSESSMENT!* This occurs because there is decreased blood flow occurring from the
coronary arteries to the heart tissues which causes pain.
2. Vital Signs.
3. SOB/Dyspnea/DOE.
4. Edema or weight gain.
5. Palpitations (the sensation of rapid HR to the point where the patient is aware of it =
not normal).
6. Fatigue or weakness.
7. Dizziness or syncope/fainting.
8. Auscultate heart sounds: S1 and S2 (*S1 is best heard at the fifth intercostal space to
the left of the sternum at the apex and S2 is heard best at the base of the heart, the area
between the apex and the sternum*). Remember: S1 at apex, S2 at the base.
What should the nurse ask the patient about any pain they may be experiencing related
to a possible perfusion issue? - Answer Pain Assessment = PQRST.
*P = Provocation/Palliation:*
, What where you doing when the pain started? What caused it? What makes it better?
Worse? What seems to trigger it? Stress? Position? Certain activities?
What relieves it? Medications, massage, heat/cold, changing position, being active,
resting?
What aggravates it? Movement, bending, lying down, walking, standing?
*Q = Quality/Quantity:*
What does it feel like? Use words to describe the pain such as sharp, dull, stabbing,
burning, crushing, throbbing, nauseating, shooting, twisting or stretching.
*R = Region/Radiation:*
Where is the pain located? Does the pain radiate? Where? Does it feel like it
travels/moves around? Did it start elsewhere and is now localized to one spot?
*S = Severity Scale:*
How severe is the pain on a scale of 0 to 10, with zero being no pain and 10 being the
worst pain ever? Does it interfere with activities? How bad is it at its worst? Does it force
you to sit down, lie down, slow down? How long does an episode last?
*T = Timing*
When/at what time did the pain start? How long did it last? How often does it occur:
hourly? daily? weekly? monthly? Is it sudden or gradual? What were you doing when you
first experienced it? When do you usually experience it: daytime? night? early morning?
Are you ever awakened by it? Does it lead to anything else? Is it accompanied by other
signs and symptoms? Does it ever occur before, during or after meals? Does it occur
seasonally?
What are some possible causes of pain related to perfusion issues? - Answer 1. Acute
Coronary Syndrome: an umbrella term for situations where the blood supplied to the
heart muscle is suddenly blocked.
2. Inflammatory Heart Disorders: such as Endocarditis ( inflammation of the inside lining
of the heart chambers and heart valves).
3. Chest Pain from non-cardiac issues: such as a pleural effusion (a buildup of fluid
between the layers of tissue that line the lungs and chest cavity).
4. Leg pain: radiating? DVT?
In regards to BP, what is the Mean Arterial Pressure? - Answer A term used in medicine
to describe *an average blood pressure in an individual*. It is defined as the average
arterial pressure during a single cardiac cycle.
It takes both systolic and diastolic pressures into consideration.
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