Exam 9: Endocrine, Gastrointestinal, Elimination, Immunologic Flashcards
1
Q
diabetes mellitus (DM)
A
- metabolic condition
- chronic
- impairment of production and or use of insulin
- deficiency of or reduced sensitivity to insulin
- insulin is required for cellular uptake of glucose
2
Q
insulin
A
- produced by islet cells in the pancreas
- manages and regulates glucose in blood; transports glucose from blood cells
3
Q
glucose (too much/ little/ just right)
A
- too much: crystalize blood vessels and causes them to break (small ones first), more common in type II, damages blood vessels, kidneys, liver, eyes, nerves, etc.
- too little: damage heart, brain, and other tissues/organs
- perfect amount: energizes, mentally sharp, protects from starvation, produces protein needed for muscles
4
Q
type I
A
- body doesn’t produce enough insulin bc…
- autoimmune factors: body attacks and destroys pancreatic cells needed for production
- NOT caused by overconsumption of glucose
- early onset
- requires insulin replacement
- injections, shots, glucometer (monitor levels)
5
Q
signs & symptoms (type I)
A
- polyuria
- polydipsia
- polyphagia
- anorexia = weight loss
- increased fatigue
- diaphoresis
- hyperglycemia
- muscle cramps
- digestion problems
- chest pain
- nausea
- irritability
- blurred vision
6
Q
type II
A
- adult onset
- initially may not need insulin
- excessive glucose in blood over time due to diet, genetics, age
- pancreas wears out and makes less insulin OR tissues become resistant to insulin
7
Q
type II risk factors
A
- prevalent in African Americans, Latinos, Native Americans
- high sugar and fat in diet
- sedentary lifestyle increases risk
- equal between men and women
- dramatic increase from 1980-2012
- obesity
8
Q
signs & symptoms (type II)
A
- polyuria
- polydipsia
- polyphagia
- unusual weight loss
- extreme weakness/ fatigue
- frequent bladder infections
- cuts/ bruises that are slow to heal
- numbness/ tingling in hands or feet
9
Q
gestational diabetes
A
- temporary type II while pregnant
- increases risk for developing diabetes later
- baby grows too large, can struggle managing blood glucose levels post-birth
10
Q
four types of blood tests
A
- hemoglobin a-glycated: shows glucose levels for 3 mo period (A3C)
- fasting plasma glucose: checked after a fast followed by 2 hr glucose intake
- random plasma glucose
- check for type I with presence of pancreatic antibodies
11
Q
risks of DM
A
- diabetic retinopathy
- cardiac, cerebral, and peripheral vascular disease
- damages structures due to excessive glucose
12
Q
hyperglycemia 1
A
- too little insulin causing abnormally high blood glucose levels
- thirst
- heartburn
- fast and deep breathing
- headache, nausea
- abdominal pain
- blurred vision
- ketoacidosis: untreated can lead to diabetic coma; life threatening
13
Q
hypoglycemia 1
A
- insulin shock
- too much insulin and/or not enough glucose in the bloodstream
- fatigue
- headache
- drowsiness
- shallow breathing
- nausea
- need sugar, then complex carb afterwards
14
Q
diabetic neuropathy
A
- 2/3 affected
- cells don’t like having too much sugar
- nerve & tissue cells
- damage to cells
- lack of sensation, pain
- symptoms
- numbness/ tingling in hands/ feet
- intrinsic muscle atrophy in hands/feet
15
Q
diabetic vascular damage
A
- cause of 60% non-traumatic limb amputations
- foot ulcers, heal slowly, may lead to gangrene
- slow healing wounds
- chronic neuropathy
- poor peripheral circulation
- loss of sensation
- lead to LE amputations
16
Q
technology & diabetes
A
- insulin pumps
- blood glucose monitoring
17
Q
normal blood sugar
A
fasting blood sugar
- normal with DM is 100-125
- considered pre-diabetic otherwise
- normal without DM is 80-100
- random blood sugar test
- less than 200 mg/dl
18
Q
impact of DM on occupational performance
A
- cognition
- lifestyle choices, psychosocial
- (ADLs) eating, mobility, personal hygiene, dental care, foot care, skin inspection, sexual functioning
- (IADLs) home management, meal prep, tasks that require cognition due to fluctuations in glucose levels
- vision, sleep, nocturia, etc.
19
Q
role of OT in DM
A
- not treating the disease, but the effects or management of the symptoms and disease course
- education
- chronic disease management
- lifestyle changes: habits, routine, rituals
- compensatory techniques, prosthetic training
- IADL of glucose checks and insulin injection (routine, not doses)
- low vision adaptations
20
Q
hypoglycemic/ia
A
low blood glucose
21
Q
hyperglycemic/ia
A
high blood glucose
22
Q
tachycardia
A
high heart rate (100+)
23
Q
dehydration
A
loss of fluid is greater than intake of fluid
24
Q
polyuria
A
increased frequency of urination
25
Q
polydipsia
A
excessive thirst
26
Q
diaphoresis
A
increased sweating
27
Q
peripheral neuropathy
A
abnormal sensations in extremities due to damage of cells
28
Q
hypertension
A
high blood pressure
29
Q
hyperlipidemia
A
high cholesterol in blood; blood has too many lipids
30
Q
polyphagia
A
extreme hunger
31
Q
bariatric
A
related to obesity
32
Q
obesity
A
- 1 of top 10 health concerns
- diet, physical inactivity, genetics
- health disparities: environment, socioeconomic status, health literacy and access to health education
- excessive body fat
33
Q
medical management - precautions & contraindications (obesity)
A
- diet & exercise
- medications to manage secondary conditions
- psychological consultation
- bariatric surgery
- cardiac/ pulmonary stress
- risk for OA
- skin integrity
- heat intolerance
- risk to practitioner (moving a patient)
34
Q
OT role in obesity
A
- bariatric assistive technology: toileting, mobility, transfers
- decreased ROM to reach areas
- teach techniques for skin care
- energy conservation, pacing, exercise program
- self awareness & coping strategies
35
Q
hypothyroidism
A
hashimoto’s thyroiditis is autoimmune and most common type of hypothyroidism
36
Q
hyperthyroidism
A
thyroid is overactive; this causes the production of too much thyroid hormone which boosts the metabolism
37
Q
adrenal disorders
A
Cushing’s Disease, Addison’s Disease
38
Q
Pancreatitis
A
- inflammation of pancreas
- causes pain after eating
39
Q
immune system function
A
- protects against disease by identifying and killing pathogens
- detects wide variety of agents (viruses)
- distinguish from healthy cells in order to function properly
- protect body from foreign invaders
- sends out different types of cells to kill germs
- complex network of cells, tissues, and organs
40
Q
germs
A
- neutrophils & macrophages eat and destroy germs
- phagocytosis
- germs, bacteria, viruses, parasites
41
Q
multiple sclerosis
A
- autoimmune and immunologic in origin
- demyelination (CNS: sensory, motor, emotional, cognitive, etc.)
- death of nerves and scar tissue visible on MRI
- degenerative disease
42
Q
OT intervention in MS
A
- PT may have exacerbations and periods of stable symptoms
- fatigue is large factor
- teach energy conservation and fall prevention techniques
- assist in coping with emotional challenges
- encourage acceptance of adaptive equipment when needed
teach safe techniques for ADL performance - teach compensation for sensory loss
43
Q
types of cancer
A
- carcinoma
- sarcoma
- chondroma
- lymphoma
- leukemia
- melanoma
44
Q
-emia
A
blood
45
Q
-oma
A
abnormal growth
46
Q
neoplasms/ cancer
A
CA
- proliferations of abnormal cells
- malignant
- benign
- metastatic (spread)
- biopsy lymph nodes near original tumors
- cause fatigue which affects managing ADLs and IADLs
47
Q
OT intervention with cancer
A
- coping strategies
- energy conservation
- task simplification
- strengthening or endurance improvement
- healing after surgery (stretching, soft tissue management)
- compensation for loss of body structures or functions
48
Q
4 main functions of lymphatic system
A
- collecting lymph from the body’s interstitial spaces
- filtering the lymph through lymph nodes
- detecting and fighting infection in the lymph nodes
- returning the lymph to the bloodstream
* linked to immune and cardiovascular systems
* valves to prevent backflow; skeletal muscle contractions assist with drainage
49
Q
OT intervention/ treatment w/ lymphatic system/ lymphedema
A
- energy conservation
- strength training
- ADL
- adaptive equipment
- positioning
- palliative care/ comfort care
- caregiver education
50
Q
lymphedema
A
- accumulation of fluid in soft tissue due to low volume insufficiency of the lymphatic system
- present in extremities, face, trunk, abdomen, and inner organs
- chronic & progressive
51
Q
etiology of lymphedema
A
- might occur following the removal of a sentinel node after a mastectomy; after a CVA because skeletal muscles cannot assist with contraction & drainage in extremities
- inherited, congenital malformations present at birth or develop later in life (primary)
- result of damage to the system; result of surgery or radiation therapy (secondary)
52
Q
lymphedema incidence
A
- 5% of patients will develop lymphedema in their first year following breast cancer treatment
- about 25% of patients will develop lymphedema in their lifetime
- can occur up to 30 years of treatment
- do not take bp on side where mastectomy has occurred due to risk of damaging lymph vessels or nodes
53
Q
OT treatment lymphedema
A
- (MLD) manual lymphatic drainage
- mechanical lymphatic devices such as vascompresion units
- intermittent compression units
- compression bandages/ wraps
- aquatic therapy
- exercise
54
Q
types of hepatitis
+ symptoms
A
- hepatitis a (HAV)
- hepatitis b (HBV)
- hepatitis c (HCV)
- jaundice: yellowing skin & eyes
55
Q
methicillin-resistant staphylococcus aureus (MRSA/ CA-MRSA)
A
- staph infection that occurs most frequently in health care facilities in people who have weakened immune systems
- can cause potentially life threatening infections (bloodstream, surgical site, pneumonia)
56
Q
transmission of MRSA
A
- people who already have it
- colonized (asymptomatic)
- contact with a person who has a wound infection or respiratory tract infection
- inadequate handwashing in healthcare provider can transmit it to residents
- universal standard precautions to prevent spread
57
Q
types of TB
A
- latent
- active
58
Q
latent TB
A
- exposed, but show no symptoms
- positive Mantoux
- typically doesn’t become active
59
Q
active TB
A
- active disease process
- symptomatic
60
Q
Mantoux Test
A
- injection of PPD tuberculin
- if there is a visible response on skin, it is positive (redness, swelling, raised, hard)
61
Q
if positive TB (Mantoux)
A
- always positive, unless a false positive
- need to have chest x-ray to prove it is not active
62
Q
HIV/AIDS
A
HIV: human immunodeficiency virus
AIDS: acquired immunodeficiency syndrome
** can be HIV + and not have AIDS
63
Q
diverticulosis & diverticulitis
A
bulge in the digestive tract
64
Q
constipation & bowel obstruction
A
- common with pain meds, advanced age, other medications, decreased fluid and fiber intake…. can lead to
- dangerous, often requires hospitalization, patients with complex issues may be seen by OT
65
Q
Crohn’s Disease
A
- autoimmune
- inflammation of small intestine
- causes weight loss, pain, difficulty absorbing nutrients
66
Q
ulcerative colitis
A
- involves large intestine
- causes ulcers that will bleed
67
Q
GI bleed
A
- sometimes person is unaware
- can cause anemia overtime
- watch for pale skin tone, fatigue, changes in bp
68
Q
benign prostate hypertrophy (in men)
A
- age related enlarged prostate
- interrupts of slows flow of urine
- can cause urinary retention where bladder never empties completely
- may cause male incontinence or UTIs
- will often be treated with TURP (transurethral resection of the prostate)
69
Q
UTIs
A
- older adults may not show traditional signs of pain with urination
- confusion, falls, change in function
- caused by poor perineal hygiene/ decreased fluid intake which concentrates the urine and irritates the bladder
- will cause bladder irritation and incontinence
70
Q
urge incontinence
A
- caused by bladder spasms
- treated by OT with bladder programs and timed voiding
71
Q
stress incontinence
A
- caused by pelvic floor weakness
- treated by OT with pelvic floor strengthening
72
Q
functional incontinence
A
- due to mobility impairments that are often temporary
- use commodes for easier access, toilet devices to decrease risk of falls
73
Q
end stage renal disease (ESRD)
A
- often related to diabetes
- clients often don’t urinate
- every other day dialysis
- will have a dialysis port
- must watch bp closely
- fluid intake limitations
74
Q
renal disease
A
- stage I - IV
- we often work with people in ESRD
- prone to weakness, bp changes, infections, cognitive changes if toxins build up in body
75
Q
OT interventions for renal disease
A
- falls prevention
- energy conservation
- task simplification
- adaptive equipment needs
- infection control
