Week 6
Perfusion
Learning Objectives
1. 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.
4. Differentiate normal respiratory assessment from
abnormal findings.
Learning Objectives (cont’d.)
5. Describe the integral relationship between
perfusion and oxygenation.
6. Explain the role and limitations associated
with pulse oximetry assessment.
7. Explain and utilize vital signs and peripheral
vascular assessment techniques and findings
to assess perfusion.
Perfusion – A continuous supply of
oxygenated blood to every cell in the
body through the body’s vessels.
(Pumped to all parts).
Circulatory system: a closed
system
Blood circulation through the
heart
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.
Nine pulse sites tell us that heart-pumped blood
is reaching peripheral areas of the body
What do you feel/palpate/see to
assess tissue perfusion?
Peripheral pulses and capillary
refill
Do you know your stuff?
Choking is a ventilation issue…
(airway)
Swollen tongue is a ventilation
(airway) issue
Head Trauma: potential for decreased
ventilation and possible obstruction, and
or swelling of the airway
Open System: an amputation is
perfusion issue
No oxygen to heart muscle– no perfusion,
dying muscle, and reduced pump action
which…
results in decreased perfusion to the
rest of the body
Perfusion Issue
Perfusion Issue
An irregular heart rate results in
decreased tissue perfusion
Asthma Attack
Diffusion Issue
(May observe restlessness)
Respiratory infections, such as pneumonia,
may decrease diffusion
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
c. Increased respiratory and heart
rate
Late finding in hypoxemia: cyanosis
Q. An early sign of hypoxemia is:
a. Depression
b. Euphoria
c. Fist pumping
d. Restlessness
d. Restlessness
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
b. Sit them up in a high upright position
Locating the Apical Pulse:
Left midclavicular line between the
fourth and fifth intercostal space
Locating the Radial Pulse
Become familiar with Table 22-28 on
page 1422, Classification of Blood
Pressure for Adults, in Nursing: A
Concept-Based Approach to Learning
(Volume One)
Decreased tissue perfusion is
determined by delayed capillary
refill of fingers and toes…
Correct order for assessing
posterior breath sounds…
Have the patient take slow deep
breaths through their mouth when
auscultating the lungs
Exam #2 next week:
Will include information covered
in sessions (weeks) 1, 2, 3, 4, 5,
and 6
End of Week 6