Promote quality of life healthy development and healthy behaviors across all

Promote quality of life healthy development and

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Promote quality of life, healthy development, and healthy behaviors across all life Framework An Ecological and Determinants Approach to Health Promotion and Disease Prevention The Role of Health Information Technology and Health Communication Addressing “All Hazards” Preparedness as a Public Health Issue (any disaster, be prepared). Topic Areas New to 2020 Life stages: Adolescent Health, Early and Middle Childhood, Older Adults Blood Disorders and Blood Safety Dementia, including Alzheimer’s Disease Genomics (genes in relation to disease) Global Health Healthcare Associated Infections Preparedness Quality of Life and Well-Being Social Determinants of Health Alterations in Perfusion Perfusion The flow of blood through arteries and capillaries, delivering nutrients and oxygen to cells and removing cellular waste products. (Essential to life!) Cardiac Output Volume of blood ejected by the heart in one minute; CO = SV x HR Stroke Volume Volume of blood ejected by the heart each beat Ejection Fraction – percentage (%) of how much blood is being pumped out of the ventricles with each contraction; if it is too low, perfusion will NOT take place MAP (Mean Arterial Pressure) Systolic Pressure + 2 (Diastolic Pressure) / 3 = MAP
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We need to keep this 70 mmHg or more for adequate perfusion to kidneys and brain!! Hypovolemic Shock Too little circulating blood volume causes a decrease in MAP, which = inadequate total body oxygenation Causes: dehydration, hemorrhage Oxygenation and perfusion are dependent on MAP : Total blood volume, CO, and size of vascular bed Shunting Body shunts blood from areas where it is NOT vital (peripheral areas) to areas where it is vital (brain, heart, kidneys) internally for survival. In cardiac defects, shunting occurs in areas of high pressure to areas of low pressure to maintain survival. Four Stages of Shock (***KNOW FOR TEST) 1. INITIAL STAGE: MAP 5 – 10 mmHg from baseline, mild vasoconstriction with increased HR, RR, and Diastolic BP (compensatory mechanisms try to correct: respiratory) 2. NONPROGRESSIVE STAGE: MAP 10 – 15 mmHg from baseline, moderate increased vasoconstriction with increased HR, decreased pulse pressure (PP, narrowing), chemical compensation (renin, aldosterone, ADH), decreased urinary output (saving fluid), THIRSTY, an-aerobic metabolism to non-vital organs (mild acidosis, mild increased Potassium [migrates to extracellular]) Early detection is KEY! These first two stages are fixable! You want to catch before (3). Early Clinical Manifestations (non-progressive) Apprehensive, irritability, increased HR, normal BP (possible slightly elevated DBP), Narrow PP, thirst, pallor, decreased urinary output, decreased perfusion of extremities, 02 saturation 90-95% 3. PROGRESSIVE STAGE (Life Threatening): MAP greater than 20 mmHg from baseline, anoxia (total depletion) of non-vital organs, hypoxia of vital organs, overall metabolism: anaerobic (mod. acidosis, moderate increase in K+, tissue ischemia).
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