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Clinical Conditions > Exam 9: Endocrine, Gastrointestinal, Elimination, Immunologic > Flashcards

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
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2
Q

insulin

A
  • produced by islet cells in the pancreas
  • manages and regulates glucose in blood; transports glucose from blood cells
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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
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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)
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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
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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
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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
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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
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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
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10
Q

four types of blood tests

A
  1. hemoglobin a-glycated: shows glucose levels for 3 mo period (A3C)
  2. fasting plasma glucose: checked after a fast followed by 2 hr glucose intake
  3. random plasma glucose
  4. check for type I with presence of pancreatic antibodies
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11
Q

risks of DM

A
  • diabetic retinopathy
  • cardiac, cerebral, and peripheral vascular disease
  • damages structures due to excessive glucose
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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
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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
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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
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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
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16
Q

technology & diabetes

A
  • insulin pumps
  • blood glucose monitoring
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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

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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.
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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
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20
Q

hypoglycemic/ia

A

low blood glucose

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21
Q

hyperglycemic/ia

A

high blood glucose

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22
Q

tachycardia

A

high heart rate (100+)

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23
Q

dehydration

A

loss of fluid is greater than intake of fluid

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24
Q

polyuria

A

increased frequency of urination

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25
Q

polydipsia

A

excessive thirst

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26
Q

diaphoresis

A

increased sweating

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27
Q

peripheral neuropathy

A

abnormal sensations in extremities due to damage of cells

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28
Q

hypertension

A

high blood pressure

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29
Q

hyperlipidemia

A

high cholesterol in blood; blood has too many lipids

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30
Q

polyphagia

A

extreme hunger

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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
  1. collecting lymph from the body’s interstitial spaces
  2. filtering the lymph through lymph nodes
  3. detecting and fighting infection in the lymph nodes
  4. 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

Clinical Conditions (16 decks)

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