409 5 Flashcards
Obesity
an abnormal increase in the proportion of fat cells mainly in the viscera and subcutaneous tissues of the body
Genetics accounts for ____ differences in people’s weight
30—40%
Food availability, cultural norms, and level of physical exercise account for ___ of weight differences
70%
Appetite is regulated primarily by the
hypothalamus
In the obese, the normal postprandial decline in
ghrelin levels does not occur, which can lead to increased appetite and overeating
Released from descending colon and rectum in proportion to the amount of calories consumed at a meal
Peptide YY
Peptide YY Inhibits appetite by
slowing motility
in obese people levels of peptide YY are
decreased
Cholecystokinin
Secreted in the duodenum and jejunum. Inhibits gastric emptying and sends satiety signals to the hypothalamus
Obesity may be associated with hyperactivity of the production of c____
cortisol
People prone to obesity have an “inborn” reduction in their catabolic responses to
glucose and insulin
one of the factors that decreases older adults nutrition status
Decreased visual acuity
BMI 25-29
overweight
BMI 30 to 39
obese
BMI 40
severe obesity
Waist-to-hip ratio
A number greater than 1 in men and 0.8 in women = overweight
Waist-to-hip ratio is especially important when calculating risk for
CAD
Combination of obesity, hypertension, high blood sugar, and dyslipidemia =
metabolic syndrome
With gastric sleeve surgery you don’t have to worry about
dumping syndrome because the sphincter is still there
Least invasive and least effective weight loss surgery
gastric band
Gastric sleeve: the portion of the stomach that produces ___ is removed
ghrelin
Palliative Care
not about curing; managing symptoms and improve quality of life
when should Palliative Care be started
at the beginning of the disease
Adjuvant analgesics
TCA
Benzo
Phenytoin/GABA
a normal process appetite in the dying patient that should not be confused with cachexia-anorexia syndrome
loss of appetite
Brain death occurs when
the cerebral cortex stops functioning
PATHOLOGIC GRIEF-CHRONIC GRIEF
INTENSITY DOES NOT WANE AFTER THE FIRST YEAR
CONFLICTED GRIEF
WHEN THE BEREAVED PERSON HAS NOT RESOLVED AMBIVALENT FEELINGS TOWARD THE DECEASED
ABSENT GRIEF
BEREAVED PERSON APPEARS TO BE COPING AND CARRYING ON AS IF NOTHING HAS HAPPENED
MALADAPTIVE OR DYSFUNCTIONAL GRIEF
GRIEF THAT IS PROLONGED OR UNRESOLVED
Verbal Directive
Can be given to MD with specific instructions in the presence of two witnesses
