Basics of Perfusion
Differentiate central vs tissue perfusion?
What is :Central: heart’s pumping to the whole body.
Tissue: local flow to an organ/area via patent vessels & adequate pressure.
Which labs assess intrinsic vs. extrinsic pathways?
What are aPTT for intrinsic; PT/INR for extrinsic?
Name the cardiac biomarker most specific for MI and how it’s trended in your blood work.
What is Troponin? It is used to detect rises and falls.
List two low-flow O₂ devices and one high-flow.
What are low-flow options: nasal cannula and simple mask. High-flow: Venturi or high‑flow nasal cannula.
Name the two main COPD phenotypes.
What is chronic bronchitis and emphysema?
Two signs of poor organ perfusion besides low BP.
What is decreased urine output and altered mental status (cool skin, weak pulses)?
Name the three broad steps of hemostasis.
What is vasoconstriction, platelet plug, coagulation (fibrin clot), and then fibrinolysis?
First diagnostic within 10 minutes for suspected MI.
What is a 12-lead ECG?
Name two basic airway-opening maneuvers.
What is head‑tilt/chin‑lift, jaw thrust if trauma is suspected?
Classic ABG pattern in chronic CO₂ retainers.
What is respiratory acidosis with metabolic compensation: increased PaCO₂, near‑normal pH due to increased HCO₃⁻.
•Name two causes and two signs of impaired central perfusion.
Causes: MI, HF, dysrhythmias, hypovolemia, shock. Signs: hypotension, tachycardia, cool, clammy skin, ↓ UO, and confusion.
Give one cause each: ineffective clotting vs. excessive clotting.
Ineffective: liver disease, vitamin K deficiency, anticoagulants.
Excessive: immobility, Factor V Leiden, malignancy.
Initial meds for chest pain suspected MI (name two).
What is chewable ASA, SL nitroglycerin if not hypotensive?
One safety teaching for home oxygen.
What is strict fire safety: no smoking/open flames near O₂; keep away from heat sources.
When are antibiotics indicated in a COPD exacerbation?
What is the increased sputum purulence/volume with dyspnea or suspicion of bacterial infection?
List three diagnostics that evaluate perfusion.
ECG, troponin, echocardiogram; plus ABPI, Doppler studies, stress test, lipid panel.
What does an elevated D‑dimer suggest?
Active clot breakdown (e.g., VTE/PE), but it’s nonspecific.
A patient arrives with suspected STEMI. SpO₂ is 94%, RR 18, no respiratory distress. Which typical MI intervention should you withhold initially, and why?
What is supplemental oxygen?
Do not give routinely when SpO₂ ≥ 90% and there’s no distress; it hasn’t shown benefit and may be harmful. Titrate O₂ only if SpO₂ < 90% or the patient is in respiratory distress.
One indication of suction and one documentation item.
Indication: visible/auscultated secretions or desaturation.
Document amount/colour/consistency, and patient tolerance.
Why titrate O2 carefully in COPD?
Excess O₂ can worsen hypercapnia in some individuals by diminishing the hypoxic drive and exacerbating V/Q mismatch.
State one key intervention for impaired tissue perfusion due to arterial obstruction.
Antiplatelet/anticoagulation and revascularization (e.g., angioplasty) while optimizing BP.
Consequence of excessive clotting in a deep vein of the leg.
What is DVT that can embolize to the lungs, which causes pulmonary embolism (PE)?
Two cornerstone long‑term meds in CAD secondary prevention.
What is a high‑intensity statin and anti-platelet (plus β‑blocker, ACEi/ARB as indicated)?
Key tracheostomy care priority that prevents dislodgement.
What are secure trach ties/holders, and how do they maintain appropriate cuff pressure? What is monitoring the stoma and inner cannula patency?
One noninvasive ventilation option for hypercapnic respiratory failure.
What is BiPAP (NIV) to reduce the work of breathing and improve ventilation?