CCC Exam 3

What is the definition of perfusion?

The flow of blood through arteries and capillaries, delivering nutrients and oxygen to cells.

What are the two types of perfusion discussed?

Central perfusion and tissue perfusion.

What generates central perfusion?

The force of blood generated by cardiac output.

How is cardiac output calculated?

Stroke volume times heart rate.

What components impact stroke volume?

Preload, afterload, and contractility.

What is preload?

The degree of stretching of the heart muscle before contraction.

What is afterload?

The resistance that the ventricle must overcome to eject blood into circulation.

What does contractility refer to?

The force of the heart's contraction with each heartbeat.

What is tissue perfusion?

The volume of blood reaching the target tissues, away from central perfusion.

What is required for adequate tissue perfusion?

Patent vessels, adequate hydrostatic pressure, and capillary permeability.

What happens when cardiac output is inadequate?

It leads to impaired central perfusion, resulting in a lack of oxygenated blood reaching the body's tissues.

What are potential consequences of inadequate central perfusion?

Severe issues such as stroke and heart attack.

What is impaired tissue perfusion often due to?

Vessel patency issues, such as blood clots or plaque buildup.

What are signs of impaired tissue perfusion?

Capillary refill time and color of extremities.

What can inadequate perfusion lead to if not corrected?

Cell death.

What are some signs of inadequate perfusion in infants?

Poor feeding, poor weight gain, failure to thrive, and dusky color.

What developmental issues can arise from inadequate perfusion in children?

Developmental delays, squatting, and fatigue.

What is a normal BNP value?

Less than 100.

What does BNP indicate?

It regulates blood pressure and blood volume through natriuresis and vasodilation.

What can cause a heart failure exacerbation related to BNP levels?

Missed medications or excessive salt intake.

What is the impact of extreme bradycardia on perfusion?

It can lead to inadequate stroke volume and impaired tissue perfusion.

What is the relationship between central and tissue perfusion?

Impaired central perfusion leads to impaired tissue perfusion.

What is a common assessment for tissue perfusion?

Capillary refill time.

What can plaque buildup in arteries lead to?

Impaired tissue perfusion due to occlusion.

What is the significance of hydrostatic pressure in perfusion?

It helps push blood through the vessels to target tissues.

What is the role of capillary permeability in tissue perfusion?

It allows for the flow of blood to the tissues.

What does impaired blood flow to tissues result in?

Symptoms such as cold extremities and delayed capillary refill.

How does the body compensate for inadequate perfusion?

By increasing heart rate and blood pressure to maintain blood flow.

What does a high BNP level indicate?

It indicates heart failure exacerbation, often seen at levels of 400-500 or higher.

What are the two types of EKG monitoring mentioned?

Five lead tele monitoring and 12 lead EKG.

What is the difference between five lead monitoring and a 12 lead EKG?

Five lead monitoring is continuous, while a 12 lead EKG provides a quick snapshot.

What is the purpose of a cardiac stress test?

To assess how the heart handles stress through exercise or pharmacologic means.

What is the benefit of pharmacologic stress testing?

It is quicker and used for patients who cannot exercise.

What imaging techniques can be used to assess heart function?

Chest X-rays, echocardiograms, and arterial gram.

What is the purpose of an arterial gram?

To visualize blood flow and detect blockages using injected dye.

What dietary modifications are recommended for patients with heart conditions?

Low sodium, low fat, and moderation in diet.

Why is smoking cessation important for cardiac patients?

Nicotine damages blood vessels and worsens perfusion.

What is the recommended approach to increasing physical activity for cardiac patients?

Start low and go slow, gradually increasing activity.

What should be assessed regarding a patient's medication regimen?

Adherence, affordability, and side effects.

What are antihypertensive medications used for?

To manage high blood pressure and improve central perfusion.

What is the role of antiarrhythmic medications?

To maintain stroke volume by regulating heart rhythm.

What are vasopressors used for?

To improve circulation.

What is the function of vasodilators like nitroglycerin?

To dilate blood vessels and relieve chest pain.

What is the primary concern with impaired tissue perfusion?

It is often due to a blockage.

What is the purpose of anticoagulants in tissue perfusion issues?

To prevent the enlargement of existing blockages.

What is the effect of heparin on a DVT?

It prevents the clot from getting larger but does not break it down.

What is the DASH diet focused on?

Low sodium and low fat foods.

What should patients understand about dietary changes?

They need to eat in moderation rather than eliminate all favorite foods.

What is a common misconception patients have about smoking cessation?

That it is too late to quit after years of smoking.

What is the recommended strategy for patients starting an exercise program?

Begin with walking and gradually increase intensity.

What is the importance of patient education regarding medications?

To ensure patients understand their regimen and adhere to it.

What is the significance of monitoring EKG during stress tests?

To identify irregularities in heart function under stress.

What are the potential side effects of medications that need to be discussed with patients?

Side effects that may prevent adherence to the medication regimen.

What is the role of lifestyle changes in managing heart conditions?

To address underlying conditions like hypertension and improve overall heart health.

What is the goal of collaborative efforts in treating perfusion issues?

To effectively manage and treat the underlying condition.

What is the primary function of heparin in treating a DVT?

Heparin prevents the clot from getting bigger and prevents new clots from forming.

What are thrombolytics used to treat?

Thrombolytics are used to treat conditions like stroke or heart attack by breaking up clots.

What caution should be taken when administering thrombolytics?

They should be used with caution in patients with a history of bleeding disorders, such as hemorrhagic stroke.

What is the role of lipid-lowering agents?

They prevent cholesterol from building up on vessel walls.

How does nitroglycerin function in tissue perfusion issues?

Nitroglycerin acts as a vasodilator and can be applied in paste form to the affected area.

What is the purpose of antiplatelet agents like aspirin?

They prevent platelets from aggregating and forming clots, especially after stent placement.

What is a pacemaker used for?

A pacemaker is used to regulate heart rate by providing electrical stimulation when the heart rate drops.

What is electrical cardioversion?

It is a procedure that uses electric shocks to restore a normal heart rhythm from a lethal or symptomatic rhythm.

What is the purpose of ablation therapy?

Ablation therapy is used to correct abnormal heart rhythms by destroying problematic tissue.

What does an intra-aortic balloon pump do?

It inflates and deflates to assist the heart in pumping blood effectively.

What is the significance of cardiac valve surgeries?

They repair or replace damaged heart valves, often now done non-invasively.

What is required for patients with a mechanical heart valve?

They must be on anticoagulation therapy to prevent clot formation around the valve.

What is the difference between bypass and graft surgery?

Bypass surgery reroutes blood around a blocked area, while graft surgery replaces the blocked vessel with a new one.

What is angioplasty?

Angioplasty is a procedure to open narrowed or blocked blood vessels, often involving the placement of a stent.

What is a carotid endarterectomy?

It is a surgical procedure to remove plaque from the carotid arteries to restore blood flow to the brain.

What is the purpose of a stent?

A stent is used to keep a blood vessel open after it has been widened during angioplasty.

What is the expected lifespan of a pacemaker battery?

The battery of a pacemaker typically lasts about ten years.

What is the role of sedation during electrical cardioversion?

Sedation is used to ensure patient comfort and safety during the procedure.

What does a successful ablation therapy result look like?

Immediate normalization of heart rhythm if the procedure is successful.

What is the purpose of cardiac transplant?

To replace a failing heart with a healthy donor heart.

What must patients take after receiving a heart transplant?

They must take anti-rejection medications for life.

What is the purpose of monitoring a pacemaker?

To ensure it is functioning correctly and to check battery life.

What is a common complication of stent placement?

The body may try to clot around the stent, requiring antiplatelet therapy.

What is the significance of monitoring heart rhythms?

To detect and manage arrhythmias and ensure proper heart function.

What is the main goal of treatments for impaired tissue perfusion?

To restore adequate blood flow to tissues.

What is a common method for assessing carotid arteries?

Carotid ultrasound or CTA (Computed Tomography Angiography).

What is the most common EKG lead placement used in clinical settings?

The five lead EKG.

What mnemonic helps remember the placement of EKG leads?

White on the right, snow on the grass; smoke over fire.

Where is the white lead placed in a five lead EKG?

On the right arm area just below the clavicle.

Where is the green lead placed in a five lead EKG?

On the lower edge of the rib cage.

Where is the black lead placed in a five lead EKG?

On the left arm area below the clavicle.

Where is the red lead placed in a five lead EKG?

On the lower edge of the rib cage on the left side.

What is the purpose of the ground lead in a five lead EKG?

To reduce electrical interference; placed at the fourth intercostal space immediately right of the sternum.

What is the standard measurement of one large box on EKG paper?

0.20 seconds.

How long is each small box on EKG paper?

0.04 seconds.

What is the six-second method used for in EKG interpretation?

To calculate the heart rate by counting QRS complexes in a six-second strip.

How do you calculate the heart rate using the six-second method?

Count the number of QRS complexes in six seconds and multiply by ten.

What is the large box method for calculating heart rate?

Count the number of large boxes between two R waves and divide 300 by that number.

What is the small box method for calculating heart rate?

Count the number of small boxes between two R waves and divide 1500 by that number.

What does the P wave represent in an EKG?

Atrial depolarization or contraction.

What is a normal measurement for the PR interval?

0.12 to 0.20 seconds.

What does the QRS complex represent in an EKG?

Ventricular depolarization.

What is a normal measurement for the QRS complex?

0.08 to 0.12 seconds.

What does the T wave indicate in an EKG?

Ventricular repolarization.

What is the heart rate range for normal sinus rhythm?

60 to 100 beats per minute.