Overview
Introduction
Mechanical circulatory support changes both the patient's physiology and the nurse's assessment.
NCLEX-RN
NCLEX-RN
Mechanical circulatory support changes both the patient's physiology and the nurse's assessment. An intra-aortic balloon pump supports native cardiac output through timed counterpulsation, whereas a durable continuous-flow left ventricular assist device (LVAD) draws blood from the left ventricle and propels it into the aorta. Continuous flow may produce little or no palpable arterial pulsation. The device and the patient must be assessed together. A low-flow alarm can reflect reduced preload, right-ventricular failure, excessive afterload, pump thrombosis, or outflow-graft obstruction. A power change with biochemical hemolysis points in a different direction from persistent low flow without hemolysis. The RN first assesses perfusion, confirms the alarm and power source, compares device parameters with the patient's baseline, and involves the specialized VAD team before any change to anticoagulation, pump speed, or controller settings.
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