The purpose of this paper is to analyze the concept of Perfusion. Perfusion refers to the flow of blood through arteries and capillaries delivering oxygen and nutrients to cells and removing cellular waste products. Perfusion is a normal physiologic process that requires the heart to generate adequate cardiac output to transport blood through blood vessels for distribution in the tissues throughout the body. The essential function of the cardiovascular system and pulmonary systems is to provide a continuous supply of oxygenated blood to every cell in the body (Pearson, 2010).
Background Information
The clinical experience used to illustrate the concept of Perfusion as it relates to a 74-year old female client who lives with her son and daughter-in-law. The patient was admitted to the hospital on February 5, 2014, with a history of hypertension and atrial fibrillation (On Coumadin) and presented with an acute left middle cerebral artery territory stroke. The client was treated on the telemetry unit for observation with active atrial fibrillation.
The patient’s experience relates to the concept of Perfusion since blood clots may interfere with adequate blood flow. Ischemic stroke is a sudden loss of function resulting from disruption of the blood supply to a part of the brain (Brunner and Suddarth, 2010). The presence of partial blockage of the blood vessel can be due to vasoconstriction, platelet adherence, or fat accumulation and therefore decreases elasticity of vessel wall leading to alteration of blood perfusion with the initiation of the clotting sequence. This may later lead to the development of thrombus which can be loosened and dislodged in some areas of the brain such as mid cerebral carotid artery th...
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...tracranial pressure from brain edema. Interventions include administering osmotic diuretics, maintaining partial pressure of carbon dioxide, and positioning to avoid hypoxia. Other treatment measures include elevating the head of the bed to promote venous drainage and to lower ICP.
Oxygen should be provided as needed, and the patient should be placed on seizure precautions. The patient should be positioned with the head of the bead at 30 degrees to avoid aspiration. Safety measures must be in place.
The patient should remain NPO until a swallow evaluation is performed. Nursing management also includes monitoring body temperature with a goal of maintaining a normal temperature and normal fluid balance, along with stabilizing blood sugars.
The nursing process in caring for clients who have suffered a CVA and treated with anticoagulants is as follows:
Stroke occurs when the blood supply to the brain is blocked or condensed. Blood works to transport oxygen and other beneficial substances to the body’s cells and organs, as well as the brain. There are two main types of strokes that are known as Ischemic strokes and Hemorrhagic strokes. When the blood vessels that provides for the brain becomes congested, is it referred to as ischemic stroke, the most common stroke within adults. Blood clots, a cluster of blood that sticks together, are the cause of Ischemic strokes. Ischemic strokes also takes place when arteries become backed up with plague, leaving less blood to flow. Plague is cholesterol, calcium and fibrous and connective tissue that sticks to the walls of blood vessels. Ischemic strokes eternally damage the brain and cause a person's body to no longer function habitually.Some risk factors that may increase stroke are high cholesterol, diabetes, high blood pressure, and obesity. Some stroke factors are also due to old age or having a family that has a history of strokes. Men are more likely to have a stroke but the most st...
...cannot attend to it alone. The nurse must be able to understand and organize a multi-dimensional approach to care. During my clinical experience I was able to work with CNA’s, LPN’s and RN’s. This allowed me to learn from their experience and to deliver better care as a result. I also worked with members of my own team and we each learned from each other’s strengths and weakness.
During this time, it is important for an off going nurse to let the oncoming nurse know that if there any operative test scheduled for the patient or if there are any special instruction that she should be aware of. For instance, if the patient needs to be NPO( nothing by mouth) the coming off nurse should inform the oncoming nurse, so she can make sure that the other staff who is involved in the care is aware of that as well. Most importantly, if the patient is scheduled to go for any kind of surgery, then the off-going nurse should also inform the oncoming nurse about patient’s belonging and if there is anything is valuable that needs to
The World Health Organisation (2013) explains that an Ischaemic stroke occurs as a result of a blood vessel becoming blocked by a clot, reducing the supply of oxygen to the brain and, therefore, damaging tissue. The rationale for selecting Mary for this discussion is; the author wishes to expand her evidenced based knowledge of stroke since it is the principal cause of disability and the third leading cause of mortality within the Scottish population (Scottish Intercollegiate Guidelines Network (SIGN), 2008) and, therefore, a national priority. In response to this priority, the Scottish Government (2009) produced their ‘Better Heart Disease and Stroke Care Action Plan’. Additionally, they have introduced a HEAT target to ensure 90% of stroke patients get transferred to a specialised stroke unit on the day of admission to hospital (Scottish Government, 2012).
The nurse needs to recognize the limitations of each staff member and learn what assignments are within the scope of their practice and what are tasks that need delegation. Delegation is defined as a complex process that requires clinical judgment and final accountability for patients’ care (Weydt, 2010). An assignment is defined as “giving someone else a task within his/her own practice and is base on job descriptions and policies” (NCSBN, 2005, p. 1). The Board of Registered Nursing (BRN) and the Board of Vocational nursing & Psychiatric Technicians (BVNPT) website, lists what duties the RN and the LVN can legally do and is within their scope of practice, this is called the ‘nurse practice act’. A nurse assistant personnel (NAP) or Unlicensed Assistive personnel (UAP) may perform different tasks depending on the state that they reside in, but most include tasks that are considered activities of daily living (ambulating, hygiene, grooming)(NCSBN, 2005). The LVN can perform tasks that the nursing assistant can do, as well as other tasks which include: medication administration (oral, subcutaneous, intramuscular), simple dressing changes, wound care, suctioning, catheter insertion, drawing blood from a patient, and starting an IV and intravenous fluids. IV and blood draws are dependent on the LVNs certification, competence, and
The circulatory system and respiratory system share a highly important relationship that is crucial to maintaining the life of an organism. In order for bodily processes to be performed, energy to be created, and homeostasis to be maintained, the exchange of oxygen from the external environment to the intracellular environment is performed by the relationship of these two systems. Starting at the heart, deoxygenated/carbon-dioxide (CO2)-rich blood is moved in through the superior and inferior vena cava into the right atrium, then into the right ventricle when the heart is relaxed. As the heart contracts, the deoxygenated blood is pumped through the pulmonary arteries to capillaries in the lungs. As the organism breathes and intakes oxygenated air, oxygen is exchanged with CO2 in the blood at the capillaries. As the organism breathes out, it expels the CO2 into the external environment. For the blood in the capillaries, it is then moved into pulmonary veins and make
The Circulatory System is a transportation and cooling system for the body. The Red Blood Cells act like billions of little mail men carrying all kinds of things that are needed by the cells, also RBC's carry oxygen and nutrients to the cells. All cells in the body require oxygen to remain alive. Also there is another kind of cells called white blood cells moving in the system. Why blood cells protect from bacteria and other things that are harmful. The Circulatory system contains vein arteries, veins are used to carry blood to the heart and arteries to carry the blood away. The blood inside veins is where most of the oxygen and nutrients are and is called deoxygenated and the color of the blood is dark red. However, blood in the arteries are also full of oxygen but is a bright red. The main components of the circulatory system are the heart, blood, and blood vessels.
The nursing process is one of the most fundamental yet crucial aspects of the nursing profession. It guides patient care in a manner that creates an effective, safe, and health promoting process. The purpose and focus of this assessment paper is to detail the core aspects of the nursing process and creating nursing diagnoses for patients in a formal paper. The nursing process allows nurses to identify a patient’s health status, their current health problems, and also identify any potential health risks the patient may have. The nursing process is a broad assessment tool that can be applied to every patient but results in an individualized care plan tailored to the most important needs of the patient. The nurse can then implement this outcome oriented care plan and then evaluate and modify it to fit the patient’s progress (Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P., 2011). The nursing process prioritizes care, creates safety checks so that essential assessments are not missing, and creates an organized routine, allowing nurses to be both efficient and responsible.
Westhead, C. (2007). Perioperative Nursing Management of the Elderly Patient. Canadian Operating Room Nursing Journal, 25(3), 34-41. Retrieved from http://gateway.library.qut.edu.au/login?url=http://search.proquest.com.ezp01.library.qut.edu.au/docview/274594603?accountid=13380.
ANA describes “The Scope of Nursing Practice (as) the “who,” “what,” “where,” “when,” “why,” and “how’ (8).’ In other words, it is the responsibility of the nurse to know who their patient is, what the patient’s diagnosis and treatment are, where it is they will be delivering treatment, the rationale behind their actions, and how they will deliver the care. By following the scope of practice, nurses reduce avoidable errors and are aware of the liability their actions entail. The ANA also puts forth a nursing process to guide nurses in treatment. The constantly evolving process is currently assessment, diagnosis, identification of outcomes, planning, implementation, and evaluation (ANA 9). Though this method has dramatically improved nursing care, it may be necessary to repeat steps to adapt to a patient’s changing needs and pathologies. By following guidelines set by the ANA, nurses are able to better connect with their patients and instill the image of professionalism to the public while also optimizing safety
So that, the diagnostic and therapeutic course of management should have been commenced sooner. Contacting other therapeutic members and explaining the situations to different people including nurse manager, consultant, senior registrar and anaesthetists have delayed the management. However, I believe that my action benefitted the patient and his family by avoiding further delay in the management. And also, ensuring the presence of a staff member with Michael’s wife should have assisted her to go through the unforeseen situation. I understand the neurological deterioration of GCS >8 and respiratory distress are indications of intubation of neuroscience patients. However, intubation is also indicated for therapeutic and diagnostic procedures in aggressive and uncooperative patients (Souter & Manno 2013). This scenario highlights the importance of the person-centred approach to clinical judgement and decision
Cerebrovascular Accident a) Overview - definition and the effects of the stroke on the body A stroke is a serious, life-threatening medical condition that occurs when the blood supply to part of the brain is cut off. (http://www.nhs.uk/conditions/Stroke/Pages/Introduction.aspx) This condition is a common cause of death and disability, especially in older people. Some predisposing factors include: • hypertension • atheroma • cigarette smoking • diabetes mellitus It occurs when blood flow to the brain suddenly interrupted, causing hypoxia. The effects include paralysis of a limb or one side of the body and disturbances of speech and vision.
I realized it was a stroke,” –Fred, a stroke survivor. Some of the most common symptoms indicating that a stroke is occurring include sudden numbness or loss of movement in the limbs on one side of your body or face, sudden vision changes, sudden trouble speaking, sudden confusion, a very intense headache, or sudden balance issues. Stroke is simply acquired when the blood supply to the brain is suspended, but to get to the roots of what causes it, a stroke is triggered by the slowly forming plaque buildup over time. The plaque is made up of calcium, fat, cholesterol, cellular waste, and fibrin, a material involved in blood clotting. The plaque existing in an artery can grow big enough to block the supply of blood to the brain, resulting in a stroke. A stroke can also be caused by high blood pressure breaking a blood vessel in the brain causing internal bleeding. Although there is no cure, as damage the brain is usually irreversible if not cared for quickly; there are different treatments available for both types of stroke. For an ischemic stroke, a tissue called plasminogen activator can be injected into an artery to break up
Stroke is a serious medical condition that affects people of all ages specifically older adults. People suffer from a stroke when there is decreased blood flow to the brain. Blood supply decreases due to a blockage or a rupture of a blood vessel which then leads to brain tissues dying. The two types of stroke are ischemic stroke and hemorrhagic stroke. An ischemic stroke is caused by a blood clot blocking the artery that brings oxygenated blood to the brain. On the other hand, a hemorrhagic stroke is when an artery in the brain leaks or ruptures (“About Stroke,” 2013). According to the Centers for Disease Control and Prevention (CDC), “Stroke is the fourth leading cause of death in the United States and is a major cause of adult disability” (“About Stroke,” 2013). Stroke causes a number of disabilities and also leads to decreased mobility in over half of the victims that are 65 and older. The CDC lists several risk factors of stroke such as heredity, age, gender and ethnicity as well as medical conditions such as high blood pressure, high cholesterol, diabetes and excessive weight gain that in...
Nurses are an equally important part of each client’s life. Nurses provide stable care to each client, answers their questions, gives medications and treatments, and assists with medical procedures. They also have the responsibility to explain to clients and family members what they should and should not do as they go through treatment and recovery. Nurses must quickly respond to patients needs. Every individual nurse has his or her own unique way of caring. There are so many ways to show caring that the possibilities are never ending. Nurse’s support, comfort, and help allow the patients to recover to the best of their ability. Their experiences in dealing with different patients that have unique situations on a daily basis helps the nurses become better caregivers. Therefore, every nurse is capable of demonstrating care in their respective environments.