Long Term Complications of Diabetes Flashcards
BP that is considered Hypertensivea
140/90
What happens to the capillaries in retinopathy?
they thicken
After capillaries thicken in retinopathy, edema is present which leads to what?
tiny aneurysms that occur and rupture
During nephropathy, the glomeruli thicken which causes what to be lost in urine? Thicking increases pressure which causes?
protein is lost in urine, thickening increases pressure which results in HTN
Why are people with nephropathy prone to hypoglycemia?
because insulin is excreted by the kidneys & if your kidneys don’t work then the insulin wont be excreted hence you’ll become hypoglycemic
What kind ofproblems can you have with nephropathy?
Neurogenic bladder(UTIs), Impotence/Erectile Dysfunction (ED)
S/S of nephropathy
Edema, Albumin in urine, HTN, Elevated Kidney function tests: BUN 24 hr creatine clearance
What might you need if you have nephropathy and you r body cant clear waste products?
Hemodialysis, peritoneal dialysis, kidney transplant
Autonomic Neuropathy s/s
Absence of sweating in hands & feet, & dry skin prone to breakdown, fixed heart rate, postural hypotension, loss of sensation (silent MI)
Elavil (amitriptyline), Neurotontin (Gabapentin), NSAIDs, ASA & Ticlid-antiplatelet meds are used for pallative care for?
Neuropathies
Lanolin lotion is used for?
Foot care (do not put between toes)
Should you use a heating pad or hot water bottle on feet with neuropathies?
No
Gastroparesis is what?
the delayed gastric emptying
If someone has gastroparesis, should they eat a high fiber diet?
no. They should also eat small frequent meals
Metoclopramide (Reglan) is used for what?
people with gastroparesis. It stimulates stomach contractions
Which disease increases secretion of adrenal hormone *Hypercortisolism)? Cushings or Addisons?
Cushings
Which disease decreases secretion of adrenal hormones? Cushings or Addisons?
Addisons
Which electrolyte is elevated in Addisons?
potassium.
With Addisons, the effects of decreased cortisol includes:
Hypoglycemia, N/V, Weight loss, Elevated BUN due to protein broken down for energy needs.
Will people who have Addison has a loss of hair?
yes
Will a person who has Addisons BP be low or high?
low
s/s of addisons disease
muscle weakness, anorexia, GI symptoms, fatigue, emotional liability, depression, confusion
What can cause Addisons Crisis
autoimmune disorder destroys adrenal cortex, abrupt withdraw from steroids
Addisons Crisis s/s
high fever, acutely ill, hypoglycemia, cardiac dyshyrimas
What teaching would you give to a Addisons patient?
high Na+ & low K+ diet, carry injectable hydrocortisone for emergency
Cushings: effects of increased cortisol:
increased Na+ & water retention, decreased K+ (excreted by kidney in exchange for retained sodium), hyperglycemia, elevated BUN (protein is broken down & converted into glucose in the liver), muscle atrophy (wasting), thin skin, bruising from fragile vessels
Cushings s/s
increased body fat, buffalo hump, depressed immune system, prone to ulcers, severe fatigue, weak muscles
will BP be high or low in Cushings?
high
What happens to bone density in with long term use of steriods in Cushings syndrome?
it gets decreased
If Cushings is caused by a tumor what treatment options are there after removing it with surgery?
life long hormone treatment
Metytapone is used to help control Cushings symptoms by?
inhibiting cortisol synthesis
Somatostatin is used to help control Cushings symptoms by?
suppressing ACTH secretion
What is Pheochromocytoma?
Tumor in the adrenal medulla
How does Pheochromocytoma effect BP?
it causes severe HTN
Catcholamines are released from what?
the tumor on the adrenal cortex in pheochromocytoma
s/s of pheochromocytoma
systolic BP 200-300 palpable mass on kidney, 5 p’s: Severe hypertension, headache, hypermetabolism, hyper sweating, hyperglycemia
5 ps are indicative of what? Severe hypertension, headache, hypermetabolism, hyper sweating, hyperglycemia
Pheochtomocytoma (Tumor on adrenal cortex)
Alpha Blockers, Minpres, Hytin, Beta blockers, Atenolol, Inderal LA are used for?
Pheochtomocytoma,
Minpres, Hytrin do what?
cause periheral vasodilation
Inderal LA does what?
slows heart rate and blocks norepinephrine
