Perfusion
1. In your own words, differentiate peripheral perfusion versus central perfusion
2. The following patient scenarios reflect peripheral perfusion or central perfusion. Review each case and determine which type of perfusion applies (peripheral or central) and provide three appropriate assessments and three appropriate interventions with rationales that these patients will need (total of four cases).
A. Patient with a history of coronary artery disease, diabetes, and hypertension presents to the emergency room with complaints of chest pain, nausea, and shortness of breath. The patient is diagnosed and admitted for stable angina. What type of perfusion applies to this case? What are the appropriate assessments and interventions for this patient?
B. Patient with a history of type I diabetes, osteoarthritis, obesity, atherosclerosis and arterial occlusive disease. Patient presents to the doctor’s office with complaints of increased pain when ambulating but states, “The pain goes away when I stop walking.” What type of perfusion applies to this case? What are the appropriate assessments and intervention for this patient?
C. Patient with a right distal radius fracture after a recent motor vehicle crash. A cast was applied and one week later presents to the emergency room with complaints of extreme pain not relieved by prescribed pain medication. Patient rates pain 10/10, unable to move fingers, and has +2 edema. What type of perfusion applies to this case? What are the appropriate assessments and intervention for this patient?
D. Patient post-op for an anterior cervical fusion of the spine has just finished surgery. Report from the operating room (OR) nurse to the post-anesthesia care unit (PACU) nurse includes that during surgery the estimated blood loss (EBL) was 800 mL. Vital signs include: 89/52, 120, 16, and a temperature of 98.6 degrees Fahrenheit. The patient’s pulse oximeter reading is 93% on 2 liters nasal cannula (NC). The patient is drowsy, has CRT’s >3 seconds, and is restless. What type of perfusion applies to this case?
What are the appropriate assessments and interventions for this patient? (1 point)
E. Reflect on the overall concept of perfusion after planning client specific interventions and treatments (ONE reflection for all cases).