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PHTH 536 - Body Systems > Endocrine - Therapeutic Interventions > Flashcards

Endocrine - Therapeutic Interventions Flashcards

1
Q

Patient education

Daily foot inspection

A

Need for the heels to toes and in between
- use a mirror or family member for assistance

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2
Q

Patient education

Screening sensation

A

screen monthly at home using LEAP protocol

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3
Q

Patient education

Checking the feet

A
  • checking shoes daily
  • wash feet daily in warm water while making sure to dry completely and apply moisturizer to feet
  • cut the toenails while asking the podiatrists or foot care specialists
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4
Q

Patient education

What is recommended to wear?

A
  • white cotton or synthetic, soft moisture wicking socks
  • wear properly constructed shoes (allowing 1/2 between toes and front of shoe)
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5
Q

Patient education

What do we suggest to avoid?

A
  • walking barefoot
  • use of hot water or heating pads on feet that can cause burns
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6
Q

What is the lower extremity amputation prevention (LEAP)?

A

A comprehensive program that can aide to decrease risk factors to prevent amputation in people with loss of protective sensation

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7
Q

What are the components of LEAP?

A
  1. Annual foot screening
  2. Patient education
  3. daily foot inspection
  4. footwear selection
  5. management of simple foot problems
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8
Q

What is the primary goal to help in wound healing?

A

Pressure offloading to relieve abnormal pressures that is applied to an ulcer

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9
Q

What is the total contact casting?

A

Molded plaster cast = helps pressure to be equally distributed to the entire LE

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10
Q

What is suggested to off-load the pressure over the surface of the ulcer?

A

Modified shoes and application of dressing

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11
Q

When does charcot foot occur?

A

With severe peripheral neuropathy and repeated trauma

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12
Q

What is the sx of charcot foot?

A
  • loss of protective sensation = abnormal response to repeated injury and severe destruction
  • unilateral observation = red, hot, swollen, flat and profound deformity
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13
Q

Charcot Foot - Stages of Development

Stage 0

A

inflammatory period
- onset of warmth, swelling, pain

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14
Q

Charcot Foot - Stages of Development

Stage 1

A

destruction period
- ligaments are weak
- joints sublux and/or dislocation

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15
Q

Charcot Foot - Stages of Development

Stage 2

A

Formation of bone callus
consolidation of fractures

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16
Q

Charcot Foot - Stages of Development

Stage 3

A

fixed deformity adn instability

17
Q

What are the benefits of exercise?

A
  • improve glycemic control
  • improve body composition and weight reduction
  • decrease hyperlipidemia and HTN
  • slows down CVD development
  • reduced stress
  • improve well-being and QOL
18
Q

What are the considerations for exercise?

A
  • consider any comorbidities and physical changes
  • consider baseline exercise abilities and progress if needed
19
Q

ACSM guidelines

How is the frequency changed in different exercise types?

A

aerobic
- no more than 2 days consecutive w/o activity

resistance
- preferred 3 days/wks
- min 2 non-consecutive days

flexibility and balance
- > 2-3 days/wk
- for both

20
Q

ACSM guidelines

How is intensity changed in different exercise types?

A

Aerobic
- mod to vigorous based on subjective

resistance
- mod (50-68% of 1RM) to vigorous (70-85% of 1RM)

flexible and balance
- stretch to point of tightness or slight discomfort
- balance exercise light-mod intensity

21
Q

ACSM guidelines

How is time changed in different exercise types?

A

Aerobic
- T1DM and T2DM 150 min/wk
- at mod-vigorous intensity

resistance
- 8-10 exercises @ 1-3 sets
- 10-15 reps to near fatigue per set

flexibility and balance
- static stretch holds for 10-30 sec and 2-4 reps per stretch
- balance = any duration

22
Q

ACSM guidelines

How is type changed in different exercise types?

A

aerobic
- prolonged
- rhythmic activities using large muscle groups

resistance
- resistance machines and/or free weights

*flexibility and balance *
- static
- dynamic
- other stretching
- yoga

23
Q

Relative contraindications

What to do with blood glucose levels with 70-100 mg/dL

A

Get a snack

  • 15g carbs every hour for mild-mod intensity
  • 25-50g with mod-vigorous intensity
  • hydration
24
Q

Relative contraindications

What to do with blood glucose levels with 100-300 mg/dL

A

Proceed to exercise

  • strenuous activity or long-duration (>1-2hrs) needs increased carb intake
  • hydration
25
Q

Relative contraindications

What to do with blood glucose levels with >300 mg/dL and on oral meds

A

Trial of 10-15 min of activity then recheck blood glucose

  • if BG rises = stop
  • if BG drops = continue and check every 10-15 mins
26
Q

Relative contraindications

What to do with blood glucose levels with >300 mg/dL and on insulin

A

Check for ketones

  • (+) = stop activity
  • (-) = activity with close BG monitor every 10-15 min
27
Q

Absolute contractindications

What is the value of hypoglycemia that is a contraindication?

A

< 70 mg/dL

28
Q

Absolute contraindications

What is the sx of hypoglycemia?

A
  • shakiness
  • dizziness
  • sweating
  • hunger
  • headache
  • pale skin
  • behavior changes
  • clumsy/jerky movements
  • seizure
  • tingling sensation around the mouth
29
Q

Absolute contraindications

What is the value of hyperglycemia that is a contraindication?

A

over 300 mg/dL with ketones

30
Q

Absolute contraindications

What is the sx of hyperglycemia?

A

SOB
breath smells fruity
nausea and vomiting
very dry mouth

31
Q

What is the most common acute concern for exercise?

A

hypoglycemia

32
Q

What is the more severe sx of hypoglycemia?

A
  • headache
  • visual disturbances
  • mental dullness
  • confusion
  • amnesia
  • seizures
  • coma
33
Q

When do episodes occur during exercise for hypoglycemia?

A

most commonly during and right after exercise but can go up to 12+ hours post exercise

people need to monitor properly to eat or medications to manage sx

34
Q

With people with diabetes, what do they need to be aware of?

A

Hypoglycemia - during, right after or up to at least 24 hours after

35
Q

What is “balancing act” for diabetes and exercise?

A

To balance between insulin adminstration, food intake and exercise

36
Q

What are the benefits of exercise for diabetes?

A

plays a central role in management of disease
- effects on glycemic control and weight loss

PHTH 536 - Body Systems (27 decks)

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