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Module 16 Perfusion
Nursing flashcards
Question | Answer |
---|---|
Stroke-The brain has auto regulation which is not effective when systemic blood pressure fall to ___ or rises above ____ Pg.1235 | 50 mmHG or 160 mmHg |
Stroke-Hypertension (increased systemic pressure) does what to the cerebral blood flow and the cerebral vessels? Pg.1235 | Increases cerebral blood flow and overdistention of the cerebral vessels |
Stroke-How long does the changes take at the cellular level when blood flow to cerebral neurons & their oxygen are interrupted or decreased? Pg.1235 | 4-5 minutes |
Stroke- What is Pneumbra? Pg.1235 | a central core of dead or dying cells is surrounded by a band of minimally perfused cells |
Stroke- What is an advantage of Pneumbra and what factors play into reestablishing homeostasis during prolonged ischemia? Pg.1235 | Advantage: if penumbra have impaired metabolic activities, they maintain their structural integrity Homeostatsis: timely return of adequate circulation, the volume of toxic products released by adjacent dying cells, & alterations in local blood flow. |
Stroke- What are the neurological deficits used to identify location? Pg.1235 | Motor pathways cross at the junction of the medulla and spinal cord (decussation), strokes lead to loss or impairment of sensorimotor functions on the side of the body opposite the side of the brain that is damaged |
Stroke- What is a Contralateral deficit? Pg.1235 | A stroke in the right hemisphere of the brain is manifested by deficits in the left side of the body, and a stroke in the left hemisphere is manifested by deficits in the right side |
Stroke-How is a stroke characterized? Pg.1235 | It is characterized by a gradual or rapid onset of neurological deficits caused by compromised cerebral blood flow. |
Stroke-What are some causes of a stroke? Pg.1235 | cerebral thrombosis, cerebral embolism, and cerebral hemorrhage |
Stroke-What can cause an ischemic stroke? Pg.1235 | Blockage or stenosis of cerebral artery. Blockage may result from a blood clot (either as a thrombus or an emboli) or from stenosis of a vessel caused by a buildup of plaque. |
Stroke- What is a lacunar infarct? Pg.1235 | Small vessel strokes, called lacunar infarcts, are small to very small infarcts in the deep, noncortical areas of the brain or the brainstem |
Stroke- What are the classifications of ischemic strokes? Pg.1235 | transient, thrombotic, or embolic |
Stroke-What are mini-strokes & how do they manifest? Pg.1235 | TIA; a brief period of localized cerebral ischemia that causes neurological deficits lasting for less than 24 hours (usually <1-2 hours) |
Stroke-How long do TIA's last and what are they a warning sign of? Pg 1235 | Deficits may be present for only minutes or may last for hours. TIAs are often warning signal of an ischemic thrombotic stroke. |
Stroke-What are some manifestations that occur with TIAs? Pg.1235 | Manifestations include contralateral numbness or weakness of the leg, hand, forearm, and corner of the mouth, Aphasia, Visual disturbances such as blurring |
Stroke- If a TIA involves the middle cerebral artery what symptoms may occur? Pg.1235 | contralateral numbness or weakness of the leg, hand, forearm, and corner of the mouth |
Stroke- If a TIA involves the posterior cerebral artery what symptoms may occur? Pg.1235 | Visual disturbances such as blurring |
Stroke- If ischemia of the left hemisphere occurs what symptoms may present? Pg.1235 | Aphasia |
Stroke-What causes thrombotic strokes and what population is the most effected? Pg.1235 | Cause:Occlusion of large vessel by thrombus (blood clot) Population: Thrombotic strokes most often occur in older individuals who are resting or sleeping |
Stroke- Where are the most commonly found thrombi? Pg.1235 | internal carotid artery, the vertebral arteries, and the junction of the vertebral and basilar arteries. |
Shock-What are the main etiologic reasons shock occurs? Pg.1222-1224 | Hypovolemic shock, cardiogenic shock, obstructive shock, disributive shock, septic shock, neurogenic shock, anaphalactic shock |
Shock-What is hypovolemic shock caused by? Pg.1222 | Caused by a decrease in intravascular volume of 15% or more This causes a decreased venous blood return=decreased ventricular filling= a decrease in SV, CO, & BP |
Shock-A decrease in circulating blood volume may trigger hypovolemic shock, what are the major leading causes to this condition? Pg.1222 | Loss of blood volume from hemorrhage, Loss of intravascular fluid from skin(burns), severe dehydration, Persistant & severe vomiting/diarrhea or nasogastric suctioning, renal loss d/t diuretic use or endocrine disorder, 3rd spacing |
Shock- what are the four stages of hypovolemic shock? Pg.1223 | Loss of blood volume, continued loss of blood volume, continued loss of blood volume, Irreversible shock |
Shock- When does cardiogenic shock occur?Pg.1223 | Heart's pumping ability compromised to point at which it cannot maintain cardiac output and adequate tissue perfusion |
Shock: What are the leading causes of cardiogenic shock? Ph.1223 | Loss of pumping action to the heart: MI, cardiac tamponade, restrictive pericarditis, cardiac arrest, dysrhythmias, valve changes, cardiomyopathies (HTN, alcohol, bacterial/viral), electrolyte imbalance, head injury, drugs |
Shock- What is the most common type of cardiogenic shock? Pg.1223 | MI |
Shock-Which Shock is the most common type? Pg.1222 | Hypovolemic shock is the most common & often occurs simultaneously with other types |
Shock- What is obstructive shock? pg.1223 | Obstruction in heart, great vessels that either impedes venous return or prevents effective cardiac pumping action |
Shock-What is a physical manifestation of cardiogenic shock?Pg.1224 | cyanotic skin, lips, & nail beds |
Shock-What is another physical manifestation of cardiogenic shock is progressing when doing a physical assessment? Pg.1224 | Jugular venous distention, this is due to increased Right arterial pressure which causes a back flow into the venous cava |
Shock-What are some causes of obstructive shock? Pg.1224 | 1. Impaired diastolic filling (e.g., pericardial tamponade or pneumothorax) 2. Increased ventricular afterload (e.g., pulmonary emboli) 3. Increased left ventricular afterload (e.g., aortic stenosis or abdominal distention) |
Shock-What is vasogenic shock? Pg.1224 | aka. distributive shock, several types of shock that result from widespread vasodilation & decreased peripheral resistance |