Specific Care Related to Patient with Altered Systemic Oxygen Transport
Oxygenation: Systemic Transport
the process of providing enough blood, oxygen and nutrients to the cells of the body
Vocabulary
• Cardiac Output- calculation
– CO= SV x HR
• Stroke volume- amt of blood ejected per heartbeat, 70ml
• Preload-is the stretch of the muscle fibers at the end of diastole
• Afterload- the pressure the ventricles must overcome to eject blood during
systole
• Vocabulary (cont.)
• Vasoconstriction
– narrowing blood vessel
• Vasodilatation
– opening of a blood vessel
• Systemic resistance
– pressure left ventricle must overcome
• Peripheral vascular resistance
– vascular resistance to blood flow
• Arteriosclerosis: diffuse process whereby the muscle fibers and the endothelial
lining of the walls of small arteries and arterioles thickens.
• Atherosclerosis: most common form of arteriosclerosis; formation of plaque in
arterial wall
• Atheroma: fibrous cap composed of smooth muscle cells forms over lipid
deposits within arteries, also called a plaque
Cholesterol
fat soluble crystalline found in animal fats, oil & egg yolks & synthesized in the body
• High Density Lipoprotein: HDL protein bound lipid that transports cholesterol
to the liver for excretion in the bile, beneficial to artery
• Low density Lipoprotein: protein bound lipid that transports cholesterol to
tissues in body, harmful effect on artery
Modifiable Risk Factors for CAD
Fasting values should be:
Total Cholesterol: <200 mg/dL
LDL "Bad" Cholesterol <100 mg/dL, <70 in very high risk pts.
HDL ("Good") Cholesterol: >40 for mg/dl for males, 50 mg/dL for females
Triglycerides: <150 mg/dL
Blood pressure: <120/80 mmHg
Fasting Glucose: <100 mg/dL
Body Mass Index (BMI): <25
Waist Circumference: <35 inches
,Anatomy Physiology Review
Efficient Systemic Transport
• Adequate cardiac pump
• Satisfactory & passable vasculature
• Sufficient blood supply
Vasculature
• Smooth lining
• Lumen patent
• Elasticity Blood vessel
Blood supply
• Cardiac volume
– RBC production
• Bone Marrow
– Renal system
CORONARY ARTERY DISEASE (CAD)
A narrowing or obstruction of one or more coronary arteries as a result of
atherosclerosis. Terms used interchangeably with CAD are arteriosclerotic heart
disease (ASHD), cardiovascular heart disease (CVHD), ischemic heart disease (IHD),
and coronary heart disease (CHD).
, Pathophysiology: Fatty deposits called atherosclerosis form in the coronary arteries
restricting blood flow to the heart, resulting in inadequate O2 supply, causing HTN,
angina, dysrhythmias, MI, HF, and death.
Atherosclerosis
– abnormal buildup of lipid deposits and fibrous tissue within the arterial
walls and lumen
Arteriosclerosis
– thickening of muscle fibers & endothelial lining of small arteries
Complications
– Angina
– MI
Risk factor same as HTN
Atherosclerosis Effect on
Coronary Blood Flow
Risk Factors Non-Modifiable Risk Factors Modifiable
(cannot be changed) (Able to change)
• Age • High cholesterol
• Gender • Hypertension
• Ethnicity • Diabetes
• Family History • Smoking
• Physical inactivity
Physiological Risk Factors
• Hypertension (also clinical manifestation)
• Diabetes Mellitus
• Obesity
• Altered lipid metabolism
– Increase cholesterol production by liver
– Increased triglycerides
– Increased LDL: LOW density lipoprotein < 100 mg/dL (Bad cholesterol)
L = Lethal
– decrease HDL: HIGH density lipoprotein > 40 mg/dL for males & >50 for
females (Good cholesterol)
Oxygenation: Systemic Transport
the process of providing enough blood, oxygen and nutrients to the cells of the body
Vocabulary
• Cardiac Output- calculation
– CO= SV x HR
• Stroke volume- amt of blood ejected per heartbeat, 70ml
• Preload-is the stretch of the muscle fibers at the end of diastole
• Afterload- the pressure the ventricles must overcome to eject blood during
systole
• Vocabulary (cont.)
• Vasoconstriction
– narrowing blood vessel
• Vasodilatation
– opening of a blood vessel
• Systemic resistance
– pressure left ventricle must overcome
• Peripheral vascular resistance
– vascular resistance to blood flow
• Arteriosclerosis: diffuse process whereby the muscle fibers and the endothelial
lining of the walls of small arteries and arterioles thickens.
• Atherosclerosis: most common form of arteriosclerosis; formation of plaque in
arterial wall
• Atheroma: fibrous cap composed of smooth muscle cells forms over lipid
deposits within arteries, also called a plaque
Cholesterol
fat soluble crystalline found in animal fats, oil & egg yolks & synthesized in the body
• High Density Lipoprotein: HDL protein bound lipid that transports cholesterol
to the liver for excretion in the bile, beneficial to artery
• Low density Lipoprotein: protein bound lipid that transports cholesterol to
tissues in body, harmful effect on artery
Modifiable Risk Factors for CAD
Fasting values should be:
Total Cholesterol: <200 mg/dL
LDL "Bad" Cholesterol <100 mg/dL, <70 in very high risk pts.
HDL ("Good") Cholesterol: >40 for mg/dl for males, 50 mg/dL for females
Triglycerides: <150 mg/dL
Blood pressure: <120/80 mmHg
Fasting Glucose: <100 mg/dL
Body Mass Index (BMI): <25
Waist Circumference: <35 inches
,Anatomy Physiology Review
Efficient Systemic Transport
• Adequate cardiac pump
• Satisfactory & passable vasculature
• Sufficient blood supply
Vasculature
• Smooth lining
• Lumen patent
• Elasticity Blood vessel
Blood supply
• Cardiac volume
– RBC production
• Bone Marrow
– Renal system
CORONARY ARTERY DISEASE (CAD)
A narrowing or obstruction of one or more coronary arteries as a result of
atherosclerosis. Terms used interchangeably with CAD are arteriosclerotic heart
disease (ASHD), cardiovascular heart disease (CVHD), ischemic heart disease (IHD),
and coronary heart disease (CHD).
, Pathophysiology: Fatty deposits called atherosclerosis form in the coronary arteries
restricting blood flow to the heart, resulting in inadequate O2 supply, causing HTN,
angina, dysrhythmias, MI, HF, and death.
Atherosclerosis
– abnormal buildup of lipid deposits and fibrous tissue within the arterial
walls and lumen
Arteriosclerosis
– thickening of muscle fibers & endothelial lining of small arteries
Complications
– Angina
– MI
Risk factor same as HTN
Atherosclerosis Effect on
Coronary Blood Flow
Risk Factors Non-Modifiable Risk Factors Modifiable
(cannot be changed) (Able to change)
• Age • High cholesterol
• Gender • Hypertension
• Ethnicity • Diabetes
• Family History • Smoking
• Physical inactivity
Physiological Risk Factors
• Hypertension (also clinical manifestation)
• Diabetes Mellitus
• Obesity
• Altered lipid metabolism
– Increase cholesterol production by liver
– Increased triglycerides
– Increased LDL: LOW density lipoprotein < 100 mg/dL (Bad cholesterol)
L = Lethal
– decrease HDL: HIGH density lipoprotein > 40 mg/dL for males & >50 for
females (Good cholesterol)
