1. Week 6 Perfusion

2. Learning Objectives
Describe and list factors that affect oxygenation and tissue perfusion.
2. Explain common physical assessment procedures
used to evaluate respiratory health of patients
across the lifespan.
3. Identify priority respiratory assessment findings.
Differentiate normal respiratory assessment from
abnormal findings.

3. Learning Objectives (cont’d. ) 5
Learning Objectives (cont’d.) 5. Describe the integral relationship between perfusion and oxygenation Explain the role and limitations associated with pulse oximetry assessment Explain and utilize vital signs and peripheral vascular assessment techniques and findings to assess perfusion.

4. Perfusion – A continuous supply of oxygenated blood to every cell in the body through the body’s vessels. (Pumped to all parts).

5. Circulatory system: a closed system
Basically a closed system….

6. Blood circulation through the heart

7. Perfusion: affected by pump failure, decreased volume, arterial obstruction Arterial walls: Blood pressure is controlled by the body with vasoconstrictors that increase pressure and with vasodilators that reduce pressure.
Perfusion – affected by pump failure, decreased volume, arterial obstruction
Arterial walls – vasoconstrict and vasodilate to help regulate BP

8. Pulse sites tell us that blood is reaching distant sites
Nine pulse sites tell us that heart-pumped blood is reaching peripheral areas of the body

9. What do you feel/palpate/see to assess tissue perfusion?
Peripheral pulses and capillary refill
Peripheral pulses and capillary refill

10. Do you know your stuff?
Do you know your stuff ?

11. Choking is a ventilation issue… (airway)

12. Swollen tongue is a ventilation (airway) issue
Swollen tongue – ventilation – airway issue

13. Head trauma think decreased ventilation and possible airway swelling
Head Trauma: potential for decreased ventilation and possible obstruction, and or swelling of the airway

14. Open System: an amputation is perfusion issue
Open system perfusion issue

15. No oxygen to heart muscle itself – it doesn’t get perfused and dies then decreased pump action and perfusion to the rest of the body
No oxygen to heart muscle– no perfusion, dying muscle, and reduced pump action which…

16. results in decreased perfusion to the rest of the body

17. Perfusion issue
Perfusion Issue

18. Perfusion issue
Perfusion Issue

19. An irregular heart rate results in decreased tissue perfusion

20. Diffusion Issue (May observe restlessness)
Asthma Attack
Asthma attack – diffusion Restlessness
Diffusion Issue
(May observe restlessness)

21. Respiratory infections, such as pneumonia, may decrease diffusion

22. Q. Our body’s compensatory mechanisms, which react in the presence of infection, include which of the following in a patient with a bilateral lung infection? a. Decreased blood pressure b. Increased blood pressure c. Increased respiratory and heart rate d. Decreased respiratory and heart rate

23. c. Increased respiratory and heart rate

24. Late finding in hypoxemia: cyanosis
Late finding cyanosis – first indication is restlessness !!!!

25. Q. An early sign of hypoxemia is: a. Depression b. Euphoria c
Q. An early sign of hypoxemia is: a. Depression b. Euphoria c. Fist pumping d. Restlessness

26. d. Restlessness

27. Q. What is the first thing you do when someone has difficulty breathing? a. Have them raise their feet b. Sit them up in a high upright position c. Give them water to drink d. Take their blood pressure

28. b. Sit them up in a high upright position

29. Locating the Apical Pulse:
Left midclavicular line between the fourth and fifth intercostal space

30. Locating the Radial Pulse

31. Become familiar with Table on page 1422, Classification of Blood Pressure for Adults, in Nursing: A Concept-Based Approach to Learning (Volume One)

32. Decreased tissue perfusion is determined by delayed capillary refill of fingers and toes…

33. Correct order for assessing posterior breath sounds…

34. Have the patient take slow deep breaths through their mouth when auscultating the lungs

35. Exam #2 next week: Will include information covered in sessions (weeks) 1, 2, 3, 4, 5, and 6

36. End of Week 6