Impaired Central Perfusion - Answers Caused by inadequate cardiac output, which leads to
reduction in oxygenated blood reaching the body tissue (systemic effect). This can lead to
ischemia, cell injury or death if untreated.
Impaired Local (Tissue) Perfusion - Answers Associated with loss of vessel patency or
permeability, or inadequate central perfusion. Results in impaired blood flow to the body tissue
(localized effect). Leads to ischemia and if untreated, will lead to cell death.
Risk Factors for Perfusion - Answers Middle-aged and older adults
Men
African Americans
Inadequate Perfusion in Infants - Answers Signs/Symptoms:
Poor feeding, poor weight gain, failure to thrive
Inadequate Perfusion in Toddlers/Children - Answers Signs/Symptoms:
Squatting and fatigue, and failure to reach milestones.
Serum Lipid Levels (Perfusion) - Answers Total lipids: 400-1,000 mg/dL
Cholesterol: <200 mg/dL
Triglycerides: Male- 40-160 mg/dL
Female- 135-145 mg/dL
HDL: F- >55mg/dL
M- >45 mg/dL
LDL: <130mg/dL
Elevations of lipids indicate CAD.
Platelets (Perfusion) - Answers 150,000-400,000 cells/mm3
Essential for blood clotting
<100,000 tends to indicate thrombocytopenia.
>400,000 tends to indicate thrombocytosis.
Prothrombin Time - Answers Measures clotting factors ability.
, 11-12.5 seconds
INR - Answers 0.8-1.1
International Normalized Ratio
Coagulation blood test
aPTT - Answers >30-40 seconds
PTT - Answers 60-70 seconds
EKG - Answers Measures heart rhythm wave deflections and heart rate
Cardiac Stress Test - Answers Can use chemical or exercise.
Monitor heart under increased stress.
Normal findings should show no change in electrical conduction and person should not have
chest pain.
Electrolytes (Perfusion) - Answers Potassium: Profound effects on HR & contractility.
Calcium: High levels can cause dysrythmias.
Magnesium: High levels slow down cardiac conduction.
Low levels increase cardiac irritability and arrthymias
Primary Prevention of Perfusion - Answers Smoking/Nicotine cessation, diet, exercise, weight
control.
Secondary (Screening) for Perfusion - Answers BP screening and lipid screening.
Interventions for Perfusion - Answers Most common strategies:
Diet modification and smoking cessation
Increased activity
Pharmacotherapy
Arteriogram - Answers Shows visualization of arteries.
Assessment for Perfusion - Answers Vital Signs: BP, apical pulse and peripheral pulses.
Auscultation of heart sounds, 2 heart sounds (lub-dub).
Skin temperature and color, check capillary refill (<2 Seconds), check if alert/orient, ask if they
have pain in legs, fingers or toes, check for edema