314 Exam 3 Flashcards
⬇️ with ⬆️ adipose
Regulates insulin sensitivity
Adiponectin
High levels of leptin lead to…
Overeating/hyperphagia
Name two proteins associated with insulin resistance
Leptin
Adiponectin
This protein expressed by adipocytes acts on the hypothalamus and is involved in satiety/appetite
Leprin
5 coexisting metabolic syndrome patholoies
Abdominal obesity
Insulin resistance
Hyperglycemia
Hyperlipidemia
Hypertension
Obesity neurological effects
Stroke
Obesity cardiovascular effects
Many heart and vascular diseases
Obesity respiratory effects
Sleep apnea
Decreased ventilation
Pneumonia
Asthma
Obesity orthopedic affects
Joints
Immobility
Obesity gastrointestinal affects
Nonalcoholic fatty liver disease
Liver cancer
Gallstones
GERD
Abdominal hernia
Obesity integumentary effects
Infection
Wounds
Obesity Genitourinary effects
Infertility Low testosterone Kidney stones BPH prostate cancer Erectile dysfunction PCOS
Obesity cancers
Breast
Endometrial
Childhood obesity treatment
Include all family and caregivers
Begin early-when family is ready
Educate family to monitor eating
Well balanced meals
Immobility ⬇️
Circulating neurotransmitters ⬇️ mood, interest, socializing.
Effects of immobility, cardiovascular
⬆️cardiac work load
⬆️risk for orthostatic hypotension
⬆️risk for venous thrombosis
Affects of immobility, respiratory
⬇️depth of Respiration
⬇️rate of respiration
Pooling of secretions
Impaired gas exchange
Nursing Interventions combating immobility respiratory problems
Incentive spirometry
Breathe in nose, out mouth
Turn patient
Effects of immobility, gastrointestinal
Disturbance in appetite
Altered protein metabolism
Altered digestion and utilization of nutrients
Decreased peristalsis
Immobility effects, Urinary
⬆️Urinary stasis
⬆️Risk for renal calculi
⬇️bladder muscle tone
Effects of immobility, musculoskeletal
⬇️muscle size tone strength ⬇️ joint mobility Bone demineralization ⬇️endurance ⬆️contracture risk
Effects of immobility, metabolic
⬆️risk for electrolytes imbalance
Altered exchange of nutrients and gases
Effects of immobility, integumentary
⬆️ risk for skin breakdown/pressure ulcers
Beginner exercise
Walking 10 minutes/3 times/week
Adult Aerobic
2.5 hours each week, at leas 10 minutes each time
Strengthening
2 days a week
Non beginners
5 hours/week
Increase effort
Five or six out of 10 is…
Moderate intensity
Seven or eight out of 10 is…
Vigorous intensity
What does DASH diet stand for?
Dietary approach to stop hypertension
NIH research shows that the dash is also good for…
Weight loss
The dash diet cuts…
Added sugars
Refined grains
Processed foods
Glycogenolysis
Liver converts glycogen to glucose
Hormone that causes glycogenolysis
Glucagon
Gluconeogenesis
Liver creates new glucose
Type of fat found in the blood
Triglyceride
Almost all body cells can use fatty acids interchangeably with glucose for energy except…
Brain
Nervous system
RBCs
The liver uses a small amount of fatty acids for its own energy needs and converts the rest into…
Ketones
These ketones are released into the…
Blood stream
Amylin
Somatostatin
Gut derived hormones
Conterregulatory
Also regulate…
Glucose
4 cell types of Islet of Langerhans:
Alpha
Beta
Delta
F/PP
Alpha cells secrete…
Glucagon
Beta cells secrete…
Insulin
Delta cells secrete…
Somatostatin
F/PP cells secrete…
Hormone of unknown function (pancreatic polypeptide)
Acini secrete
Digestive juices into duodenum
True or false:
Insulin increases protein synthesis
True
Increases transport of aa into the liver
Glucagon
Inhibits gastric emptying and glucagon secretion
Amylin
Inhibits release of glucagon and insulin
Somatostatin
Gut derived hormones
Increased insulin secretion after oral nutrient load (incretin effect).
Stimulate glycogenolysis in liver
Inhibit insulin release, decreases movement of glucose into muscle cells
Increases breakdown of muscle glycogen stores
Catecholamines such as epinephrine
Increases protein synthesis in all cells of the body
mobilizes fatty acids from adipose cells
Antagonizes effects of insulin
Growth Hormone
Stimulates gluconeogenesis
Decreases tissue use of glucose
Glucocorticoid hormones
Normal glucose levels
70-110 mg/dL
Name 4 types of diabetes
Type 1A
Type 1B
Type 2
Gestational diabetes
Prediabetes FPG range (IFG)
100-125 mg/dL
Prediabetes OGTT range (IGT)
140-199mg/dL
Prediabetes A1C
5.7-6.4%
How many hours before FPG?
8
Involves continuous glucose monitoring via catheter implanted into SQ tissue
Capillary blood glucose (CBG) monitoring
Index of glucose level for 6 to 12 weeks/2 to 3 months
Glycosolated Hemoglobin
Autoimmune beta cell destruction
1A
Unknown cause of beta cell destruction and higher frequency of DKA
1B
Condition when fatty acids released from liver and converted to ketones
DKA
Insulin treatment is required for all
Type 1A diabetes
Increased gluconeogenesis is associated with what type of diabetes?
Type 2
Theory for insulin resistance in obese people
Insulin resistance in obese people caused by increased concentrations of FFA’s
FFA’s inhibit
Glucose uptake
Risk for Gestational diabetes
Fhx of type 2 diabetes Glucosuria Obesity PCOS Hx GDM Infant large for age
Endocrine disorders linked to diabetes
Acromegaly
Cushing syndrome
Pheochromocytoma
Diuretics can impair beta cell function by
Increasing potassium loss
Diabetes causes polyphagia because
Glucose isn’t entering cells effectively
Causes of hypoglycemia
Too much insulin
Failure to eat
Increased exercise
Medication changes
Ethanol decreases
Gluconeogenesis
Extreme symptoms of hypoglycemia
Coma
Seizure
Stimulate insulin at the level of the pancreatic beta cells
Insulin secretagogues
Inhibits hepatic glucose production and increases sensitivity of insulin
Biguanides
Block the action of intestinal brush border enzymes that break down complex carbohydrates
X-glucosidase inhibitors
Only class of drugs that directly target insulin resistance
Thiazolidinedones
Hormones released into the circulation by the G.I. tract after a meal. They amplify glucose induced release of insulin
SGLT2 inhibitors
Biguanide contraindications
Elevated serum creatine
Liver disease
Hypoxemia
Dehydration
Alpha glucosidase can cause hypoglycemia when combined with
Sulfronylureas
Thiazolidinedone contraindications
Class III/IV heart failure
Bone fracture risk
4 things that lead to diagnosis of DKA
Glucose >250
Low serum bicarbonate
Low arterial pH
Urine and serum ketones
Weird thing about DKA
Fruity smell
DKA treatment
Hydration
Insulin
Electrolyte replacement
HHS has hyperglycemia >
600
HHS treatment
Hydration
Potassium replacement
Which is more severe, HHS OR DKA?
HHS
Angiotensin II raises arterial pressure via
Aldosterone
Sodium retention
Vasoconstriction
Parasympathetic to heart via
Vagus Nerve
Sympathetic to heart via
Spinal cord and peripheral nerves