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fdn-perf-06

Perfusion

Course: Foundations

Practice Questions

Fundamentals: Oxygenation Matrix 1 — Definitions

Match each description with the correct oxygenation concept.

Description Oxygenation Ventilation Perfusion Hypoxemia Dyspnea Result
Process of getting oxygen into the blood so it can be delivered to body tissues.
Movement of air in and out of the lungs through breathing.
Movement of blood through the lungs and body so oxygen can be delivered to tissues.
Low oxygen level in the blood, often reflected by decreased oxygen saturation or abnormal ABG findings.
Subjective feeling of difficult, labored, uncomfortable, or short breathing.
Respiratory rate, depth, rhythm, and effort help the nurse evaluate this process.
Results will appear here.

Fundamentals: Oxygenation Matrix 2 — Assessment Cues

Match each assessment cue with the correct oxygenation concern.

Assessment Cue Hypoxia Ineffective Airway Clearance Increased Work of Breathing Poor Perfusion Respiratory Depression Result
Client has restlessness, confusion, cyanosis, low SpO₂, or worsening shortness of breath.
Client has thick secretions, weak cough, coarse crackles, gurgling, or inability to clear mucus.
Client is using accessory muscles, nasal flaring, tripod position, retractions, or has labored breathing.
Client has cool clammy skin, weak pulses, delayed capillary refill, hypotension, or signs of shock.
Client has slow respirations, excessive sedation, shallow breathing, or decreased arousal after opioids or sedatives.
Client is sitting upright, leaning forward, and struggling to speak in full sentences.
Results will appear here.

Fundamentals: Oxygenation Matrix 3 — Oxygen Devices

Match each situation with the correct oxygen delivery device or support.

Situation Nasal Cannula Simple Face Mask Nonrebreather Mask Venturi Mask Bag-Valve-Mask Result
Client needs low-flow oxygen and can still eat, talk, and tolerate tubing in the nares.
Client needs moderate oxygen support and can tolerate a mask covering the nose and mouth.
Client needs high-concentration oxygen quickly while awaiting provider, respiratory therapy, or emergency response.
Client needs a precise oxygen concentration, commonly used when oxygen must be carefully controlled.
Client is not breathing adequately and needs manual ventilation support.
Client’s SpO₂ is 82% with severe respiratory distress; high-flow emergency oxygen is needed now.
Results will appear here.

Fundamentals: Oxygenation Matrix 4 — Intervention Matching

Match each oxygenation problem with the best nursing intervention focus.

Oxygenation Problem High Fowler’s Position Cough / Deep Breathe Incentive Spirometry Suctioning Notify Provider / RT Result
Client is short of breath and needs chest expansion improved immediately.
Client needs help mobilizing secretions and expanding lungs after immobility or surgery.
Postoperative client needs to prevent atelectasis and practice slow, sustained inhalation.
Client cannot clear secretions, has gurgling, visible mucus, or ineffective cough causing airway compromise.
Client’s respiratory status worsens despite positioning, oxygen, and basic nursing interventions.
Client has a tracheostomy with noisy breathing and thick secretions that are not cleared by coughing.
Results will appear here.

Fundamentals: Oxygenation Matrix 5 — Priority and Safety

Match each situation with the best oxygenation priority.

Situation Airway First Oxygen Safety Assess Before Oxygen Monitor Response Escalate Care Result
Client has choking, obstruction, gurgling, absent breath sounds, or inability to clear secretions.
Oxygen is in use, so smoking, open flames, petroleum products, and unsafe electrical equipment must be avoided.
Before starting or changing oxygen, the nurse checks respiratory rate, effort, lung sounds, SpO₂, skin color, and mental status.
After oxygen or positioning, the nurse reassesses SpO₂, breathing effort, lung sounds, color, and comfort.
Client remains hypoxic, becomes confused, has worsening distress, or cannot maintain airway despite intervention.
Before focusing on oxygen saturation numbers, the nurse makes sure the airway is open and breathing is adequate.
Results will appear here.
Practice questions coming soon.

Welcome to your fdn Perfusion

Definition

Perfusion is the process of delivering oxygenated blood and nutrients to body tissues and organs. Adequate perfusion is necessary for cells to function, organs to remain alive, and the body to maintain homeostasis.

When perfusion is impaired, tissues may not receive enough oxygen and nutrients, leading to dysfunction, injury, or shock.

Assessment
  • Assess heart rate, rhythm, blood pressure, and oxygen saturation.
  • Check skin color, temperature, and moisture.
  • Assess capillary refill; normal is about less than 3 seconds.
  • Check peripheral pulses for presence, strength, and symmetry.
  • Assess level of consciousness, restlessness, confusion, and dizziness.
  • Monitor urine output; normal is about 30 mL/hr or more in adults.
  • Look for edema, chest pain, fatigue, weakness, or signs of poor circulation.
Diagnostic Thinking

The nurse combines circulation findings, mental status, urine output, skin clues, labs, and vital signs to determine whether tissues are being perfused adequately.

  • Low blood pressure + tachycardia may suggest decreased circulating volume or shock.
  • Cool, pale skin + delayed capillary refill may suggest poor peripheral perfusion.
  • Confusion, restlessness, or decreased LOC may suggest decreased cerebral perfusion.
  • Low urine output may suggest decreased kidney perfusion.
  • Chest pain, dyspnea, fatigue, and edema may suggest cardiac pump problems affecting perfusion.

Labs and diagnostics that help support the picture:

  • Hemoglobin: normal is about 12 to 18 g/dL; low Hgb reduces oxygen-carrying capacity.
  • Hematocrit: normal is about 37% to 52%.
  • Lactate: normal is about 0.5 to 1 mmol/L; elevated lactate may suggest poor tissue perfusion.
  • BUN: normal is about 10 to 20 mg/dL.
  • Creatinine: normal is about 0.6 to 1.3 mg/dL; rising values may suggest kidney perfusion problems.
  • Troponin: may rise with myocardial injury.
  • EKG: helps identify dysrhythmias or cardiac ischemia affecting perfusion.
Interventions
  • Monitor vital signs, pulses, capillary refill, skin findings, and urine output closely.
  • Position the client to support circulation and perfusion as appropriate.
  • Administer oxygen or fluids as ordered and monitor response.
  • Reduce activity demands if perfusion is impaired.
  • Report significant changes promptly, especially chest pain, hypotension, or mental status changes.
  • Document findings and interventions clearly.
Skills to Master
  • Assessing peripheral pulses
  • Checking capillary refill
  • Monitoring intake and output
  • Recognizing signs of poor perfusion
  • Using focused cardiovascular assessment findings
  • Reporting urgent changes clearly and promptly
Clinical Pearls
  • A “normal” blood pressure does not always mean perfusion is adequate.
  • Mental status changes may be an early clue of poor perfusion.
  • Urine output is a major clue to kidney perfusion.
  • Students often look at BP only and forget skin, pulses, cap refill, and urine output.
  • Poor perfusion can affect every organ system quickly.
Notes / Resources

Perfusion charts, shock reminders, and cardiovascular assessment materials coming soon.

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