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Fundamentals 2 > ** Chapter 26: Endocrine > Flashcards

** Chapter 26: Endocrine Flashcards

1
Q

Fixed flexion of the hands due to a thickening of the fibrous tissue under the skin of the palm and fingers, a risk for persons with diabetes mellitus

A

Dupuytren’s contracture

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2
Q

Group of conditions (high triglycerides, low high-density lipoprotein, elevated fasting blood sugar, elevated blood pressure, and central obesity) occurring together that increase the risk of diabetes, stroke, and coronary artery disease

A

Metabolic syndrome

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3
Q

This complex system consists of glands that ___ and ___

A

synthesize and secrete hormones

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4
Q

There are two major classes of hormones:

A

Steroids and Thyronines

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5
Q

Steroids and thyronines are __ __

A

lipid soluble

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6
Q

Polypeptides and catecholamines are __ __

A

water soluble

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7
Q

With age, the thyroid gland progressively ___ and thyroid gland activity ___

A

atrophies

decreases

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8
Q

The thyroid gland atrophying and the thyroid gland activity decreasing results in: (3)
a lower __ __ rate, reduced __ __ uptake, and less secretion and release of ___.

A

basal metabolic
radioactive iodine
thyrotropin

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9
Q

Thyroid activity can be further reduced by __ __ __

A

diminished adrenal function

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10
Q

Adrenocorticotropic hormone secretion ___ with age.

A

decreases

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11
Q

The ___ of the pituitary gland decreases with age; somatotropic growth hormone blood levels may be ___.

A

volume

reduced

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12
Q

Insulin secretion is also affected by age; there is ___ release of insulin by the β cells in the pancreas and ___ tissue sensitivity to the circulating insulin.

A

insufficient

reduced

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13
Q

Many older adults have reduced ability to metabolize ___, particularly when:

A

glucose

a sudden high concentration of glucose is consumed

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14
Q

Type 2 diabetes, the ___ leading cause of death among older adults, affects __% of the older population.

A

seventh

20

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15
Q

Type 2 diabetes has a particularly high prevalence among __ __ and people who are __ to __ years of age.

A

African Americans

65-74

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16
Q

__ __ is a common occurrence among older adults, and is due to increase amounts of fat tissue in obese older adults. (diabetes)

A

Glucose intolerance

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17
Q

What 4 things are the most important contributors to diabetes mellitus?

A

Obesity, inactivity, an increased amount of fat tissue, and having a first-degree relative with the disease

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18
Q

T/F; Physiologic deterioration of glucose tolerance is no longer considered a risk factor.

A

True

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19
Q

Screening with the use of fasting blood sugar is recommended every __ years for persons over __ years of age.

A

3

45

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20
Q

Because the renal threshold for glucose increases with age, ____

A

older individuals can be hyperglycemic without evidence of glycosuria

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21
Q

Among all the diagnostic measures, the glucose ___ test is the most effective

A

tolerance

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22
Q

The American Diabetes Association recommends that a minimum of __ g of carbohydrates be ingested daily for several days before the glucose tolerance test; older, malnourished individuals may be prescribed ___ g.

A

150

300

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23
Q

Nicotinic acid, ethacrynic acid, estrogen, furosemide, and diuretics can ___ glucose tolerance.

A

decrease

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24
Q

The diagnosis of diabetes is usually established if one of the following criteria exists:

A
  • random blood glucose concentration ≥200 mg/dL.
  • Glycosylated hemoglobin (HbA1c) ≥6.5%.(over a 3 month period)
  • Fasting is ≥126 mg/dL (8-hour fast).
  • 2 hours after an oral glucose intake ≥200 mg/dL
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25
Q

Although the glycemic goals need to be individualized for the patient, the general recommendations are for the patient to achieve a fasting plasma glucose of __ to __ mg/dL, postprandial glucose of less than __ mg/dL, and hemoglobin A1c of less than __%

A

70 to 130
180
6.5

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26
Q

___ is often used to treat hyperglycemia. 1st line of treatment for Type 2 DM.

A

Metformin

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27
Q

When should Metformin be administered?

A

Immediately after meals to avoid gastrointestinal disturbances

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28
Q

If an older person with diabetes must self-inject insulin, one factor that must be considered is:

A

the patient’s ability to handle a syringe and vial of insulin

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29
Q

Most older persons have some degree of visual impairment, so the nurse must :

A

evaluate their ability to read the calibrations on an insulin syringe.

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30
Q

The hemoglobin A1c test (also called HbA1c, glycated hemoglobin test, or glycohemoglobin) measures the amount of __ __ in the blood and is used to monitor the effectiveness of disease control.

A

glycosylated hemoglobin

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31
Q

Hemoglobin A1c provides an average of the patient’s blood glucose control over a ____ period the normal range is between 4% and 6%. For persons with diabetes, the goal is HbA1c below __

A

6-12 week

7%

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32
Q

The American Diabetes Association recommends that people with diabetes maintain their triglyceride levels below __ mg/dL.

A

150

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33
Q

A diet high in complex __ and __ controls the release of glucose into the bloodstream and can reduce insulin requirements.

A

carbohydrates and fibers

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34
Q

When it comes to diabetes, nutritional supplements can reduce the risk of complications; such supplements include ___. (6)

A

vitamin B6, folic acid, riboflavin (B2), magnesium, zinc, and chromium.

35
Q

What seems to be a greater threat to older patients? Hypoglycemia or ketoacidosis?

A

Hypoglycemia

36
Q

____ is a common complication in the older individual who has diabetes and is influenced by the poorer circulation and atherosclerosis often associated with increased age.

A

Peripheral vascular disease

37
Q

Another significant vascular problem of older patients with diabetes is ____

A

retinopathy with consequent blindness

38
Q

Individuals who are hypertensive or who have had diabetes for a long time have a greater risk of developing this complication.

A

retinopathy with consequent blindness

39
Q

Many older patients taking sulfonylureas experience ___

A

hypoglycemia

40
Q

The age-related changes in hepatic and renal functions that alter drug metabolism and excretion increase the risk for __

A

hypoglycemia

41
Q

___ is also associated with impairments in the autonomic nervous system and reductions in adrenergic receptor function

A

Aging

42
Q

What drugs are known to have drug interactions with diabetes?

A

β-blockers, salicylates, warfarin, sulfonamides, tricyclic antidepressants, and alcohol

43
Q

Thyroxine (T4) and triiodothyronine (T3) are essential hormones produced by the ___ ___

A

thyroid gland

44
Q

Aging affects the thyroid gland in several ways, including:

A
  • moderate atrophy
  • fibrosis
  • increasing colloid nodules
  • some lymphocytic infiltration
45
Q

A SUBnormal concentration of thyroid hormones T4 and T3 in the tissues is known as ____.

A

hypothyroidism

46
Q

Hypothyroidism is more common in men or women?

A

women

47
Q

Primary hypothyroidism has ___ TSH.

A

elevated

48
Q

Secondary hypothyroidism has ___ TSH.

A

low

49
Q

A subclinical hypothyroidism can exist in which the person is asymptomatic but has an elevated ___ level and normal __.

A

TSH

T4

50
Q 
Symptoms of \_\_\_:
Fatigue, weakness, and lethargy
Depression and disinterest in activities
Anorexia
Weight gain and puffy face
Impaired hearing
Periorbital or peripheral edema
Constipation
Cold intolerance
Myalgia, paresthesia, and ataxia
Dry skin and coarse hair
A

hypothyroidism

51
Q

Treatment of hypothyroidism includes replacement of thyroid hormone using a __ __

A

synthetic T4

52
Q

Initially, thyroid replacement is prescribed at a __ __ and is gradually ___ under close supervision to prevent cardiac complications

A

low dose

increased

53
Q

T/F: Thyroid replacement will most likely be a lifelong requirement.

A

True

54
Q

Which is less prevalent: hyperthyroidism or hypothyroidism?

A

Hyperthyroidism

55
Q

A potential cause of hyperthyroidism in older patients that should be considered is related to the use of ___.

A

amiodarone

56
Q

___ is a cardiac drug containing iodine that deposits in tissue and delivers iodine to the circulation over very long periods of time.

A

amiodarone

57
Q

Diagnostic testing can be challenging because blood tests do not always reflect ___

A

hyperthyroidism

58
Q

T3 levels can be decreased from ____

A

decreased nutritional status

59
Q

Classic symptoms of ____ include diaphoresis, tachycardia, palpitations, hypertension, tremor, diarrhea, stare, lid lag, insomnia, nervousness, confusion, heat intolerance, increased hunger, proximal muscle weakness, and hyperreflexia.

A

Hyperthyroidism

60
Q

An autoimmune disorder that leads to the production of an antibody to the TSH receptor that stimulates thyroid growth and overproduction of thyroid hormone

A

Graves’ disease

61
Q

Changes that occur to the endocrine system with age include:

  • reductions in ___ gland activity
  • less radioactive __ uptake
  • lower ___ rate
  • less secretion and release of ____
  • decreased ___ gland volume
  • insufficient pancreatic release of ___
  • ___ secretion decreases
A 
thyroid 
iodine
metabolic
thyrotropin
pituitary
insulin
ACTH
62
Q

Enables body to metabolize energy, reproduce, grow, develop, maintain homeostasis, respond to stress & injury.

A

endocrine system

63
Q

Age-related changes are __ and ___(compensatory response)

A

diverse

inter-related

64
Q

Diagnosis of hyperthyroidism includes evaluation of what 3 things? (thyroid stimulating hormone)

A

T4, free T4, TSH

65
Q

Disease that destroys tissues in thyroid

primary or secondary

A

Primary

66
Q

Insufficient pituitary secretion of thyroid stimulating hormone (TSH)
(primary or secondary)

A

Secondary

67
Q

Treatment/management of hypothyroidism: Replacement of thyroid hormones w/ synthetic ___ (Synthroid or thyroxine)

A

T4

68
Q 
Complications of \_\_\_ includes:
Neuropathies
Retinopathy leading to blindness
Cognitive impairment
Coronary artery disease
Cerebral arteriosclerosis
Urinary tract infections (high level of glucose can do this)
Higher risk of developing problems in every body system
A

Diabetes

69
Q

Exercise and nutrition has a direct affect on __ __ __.

A

blood glucose level

70
Q

Hemoglobin (Hgb or Hb) A1C test measures the amount of ___ ___ in the blood.

A

glycosylated Hgb

71
Q

Normal Hgb is __ to ___ %

A

normal 4-6%

72
Q

For a diabetic, you want a blood glucose level less than ___%.

A

6.5%

73
Q

Hgb is used to monitor effectiveness of disease control over a _____ period of time

A

6-12 week

74
Q

Triglyceride monitoring, levels below ___ mg/dL is ideal.

A

150

75
Q

Diabetic agents have ___ as a side effect.

A

hypoglycemia

76
Q

Management of Diabetes:

A
  • implications of diagnosis
  • assessment of self-care capacity
  • reassurance and support
77
Q

General exercise ___ your blood glucose.

A

lowers

78
Q

__% of older adults are diagnosed with diabetes.

A

20

79
Q

What is metabolic syndrome?

A

A cluster of conditions that increase the risk of heart disease, stroke, and diabetes

80
Q

you’re checking the ___ ___ before giving the insulin’s and each insulin has different ___ for their effectiveness.

A

blood glucose

duration

81
Q

There is insufficient release of __ and reduced __ sensitivity to ___ insulin

A

insulin
tissue
circulating

82
Q

Is 70-130 a normal sugar?

A

YES- for anytime throughout the day

83
Q

Hemoglobin (Hgb or Hb) A1C test measures the amount of glycosylated Hgb in the blood. The normal range is:

A

4.5-6.5

Fundamentals 2 (16 decks)

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