Perfusion Basics
What are the 3 Ps of perfusion?
Pump (heart), pipes (vessels), and plasma (blood).
What does prolonged capillary refill suggest?
Poor peripheral perfusion.
What is one physical impact of impaired tissue integrity?
Pain, odor, exudate, pruritus.
What causes cool, mottled skin at EOL?
Reduced skin perfusion.
What is exsanguination?
An acute, catastrophic bleed.
What is central perfusion?
Blood movement from cardiac output requiring adequate heart function, BP, and volume.
Name one sign of impaired GI perfusion.
Abdominal pain, distention, electrolyte imbalance, absent bowel sounds.
What emotional impact may wounds cause?
Depression, fear, shame, embarrassment.
What change in cerebral perfusion is common at EOL?
Drowsiness, disorientation, terminal delirium.
Name one risk factor for catastrophic bleeding.
Liver failure, DIC, thrombocytopenia, certain cancers (head/neck, lung, gyn).
What is tissue/local perfusion?
Blood flow to target tissues requiring open vessels, pressure, and capillary permeability.
What is a common sign of impaired cerebral perfusion?
Dizziness, confusion, syncope, N/V.
What social impact can malignant wounds lead to?
Isolation due to odor, appearance, or stigma.
What is one intervention for poor renal perfusion at EOL?
Keep patient clean/dry; use Foley catheter PRN.
What is one priority during a catastrophic bleed event?
Give one sign of impaired cardiopulmonary perfusion.
Dyspnea, chest pain, cyanosis, dysrhythmia, abnormal BP, diaphoresis.
What may cold, pale, or mottled skin indicate?
Reduced skin perfusion.
What is a spiritual impact of tissue integrity changes?
Reminder of disease progression or mortality.
Why is constipation less of a concern near EOL?
Bowel function naturally slows and output decreases.
What is the first sign of a pressure ulcer?
Redness over a bony prominence.
Why must nurses prioritize perfusion cues using ABCs?
Because impaired oxygenation/perfusion can cause rapid deterioration.
Why is prioritizing "conditions that could cause significant harm" essential?
They may worsen quickly and require immediate intervention.
What is a common physical symptom of malignant wounds?
Odor, bleeding, pruritus, exudate, pain.
What medication examples support comfort during terminal delirium?
Midazolam or Nozinan.
Give one intervention for wound odor or exudate.
Charcoal, metronidazole, absorbent dressings, barrier film, cleansing.