Long Term Complications of Diabetes

Question 1

BP that is considered Hypertensivea

Answer 1

140/90

Question 2

What happens to the capillaries in retinopathy?

Answer 2

they thicken

Question 3

After capillaries thicken in retinopathy, edema is present which leads to what?

Answer 3

tiny aneurysms that occur and rupture

Question 4

During nephropathy, the glomeruli thicken which causes what to be lost in urine? Thicking increases pressure which causes?

Answer 4

protein is lost in urine, thickening increases pressure which results in HTN

Question 5

Why are people with nephropathy prone to hypoglycemia?

Answer 5

because insulin is excreted by the kidneys & if your kidneys don’t work then the insulin wont be excreted hence you’ll become hypoglycemic

Question 6

What kind ofproblems can you have with nephropathy?

Answer 6

Neurogenic bladder(UTIs), Impotence/Erectile Dysfunction (ED)

Question 7

S/S of nephropathy

Answer 7

Edema, Albumin in urine, HTN, Elevated Kidney function tests: BUN 24 hr creatine clearance

Question 8

What might you need if you have nephropathy and you r body cant clear waste products?

Answer 8

Hemodialysis, peritoneal dialysis, kidney transplant

Question 9

Autonomic Neuropathy s/s

Answer 9

Absence of sweating in hands & feet, & dry skin prone to breakdown, fixed heart rate, postural hypotension, loss of sensation (silent MI)

Question 10

Elavil (amitriptyline), Neurotontin (Gabapentin), NSAIDs, ASA & Ticlid-antiplatelet meds are used for pallative care for?

Answer 10

Neuropathies

Question 11

Lanolin lotion is used for?

Answer 11

Foot care (do not put between toes)

Question 12

Should you use a heating pad or hot water bottle on feet with neuropathies?

Answer 12

No

Question 13

Gastroparesis is what?

Answer 13

the delayed gastric emptying

Question 14

If someone has gastroparesis, should they eat a high fiber diet?

Answer 14

no. They should also eat small frequent meals

Question 15

Metoclopramide (Reglan) is used for what?

Answer 15

people with gastroparesis. It stimulates stomach contractions

Question 16

Which disease increases secretion of adrenal hormone *Hypercortisolism)? Cushings or Addisons?

Answer 16

Cushings

Question 17

Which disease decreases secretion of adrenal hormones? Cushings or Addisons?

Answer 17

Addisons

Question 18

Which electrolyte is elevated in Addisons?

Answer 18

potassium.

Question 19

With Addisons, the effects of decreased cortisol includes:

Answer 19

Hypoglycemia, N/V, Weight loss, Elevated BUN due to protein broken down for energy needs.

Question 20

Will people who have Addison has a loss of hair?

Answer 20

yes

Question 21

Will a person who has Addisons BP be low or high?

Answer 21

low

Question 22

s/s of addisons disease

Answer 22

muscle weakness, anorexia, GI symptoms, fatigue, emotional liability, depression, confusion

Question 23

What can cause Addisons Crisis

Answer 23

autoimmune disorder destroys adrenal cortex, abrupt withdraw from steroids

Question 24

Addisons Crisis s/s

Answer 24

high fever, acutely ill, hypoglycemia, cardiac dyshyrimas

Question 25

What teaching would you give to a Addisons patient?

Answer 25

high Na+ & low K+ diet, carry injectable hydrocortisone for emergency

Question 26

Cushings: effects of increased cortisol:

Answer 26

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

Question 27

Cushings s/s

Answer 27

increased body fat, buffalo hump, depressed immune system, prone to ulcers, severe fatigue, weak muscles

Question 28

will BP be high or low in Cushings?

Answer 28

high

Question 29

What happens to bone density in with long term use of steriods in Cushings syndrome?

Answer 29

it gets decreased

Question 30

If Cushings is caused by a tumor what treatment options are there after removing it with surgery?

Answer 30

life long hormone treatment

Question 31

Metytapone is used to help control Cushings symptoms by?

Answer 31

inhibiting cortisol synthesis

Question 32

Somatostatin is used to help control Cushings symptoms by?

Answer 32

suppressing ACTH secretion

Question 33

What is Pheochromocytoma?

Answer 33

Tumor in the adrenal medulla

Question 34

How does Pheochromocytoma effect BP?

Answer 34

it causes severe HTN

Question 35

Catcholamines are released from what?

Answer 35

the tumor on the adrenal cortex in pheochromocytoma

Question 36

s/s of pheochromocytoma

Answer 36

systolic BP 200-300 palpable mass on kidney, 5 p’s: Severe hypertension, headache, hypermetabolism, hyper sweating, hyperglycemia

Question 37

5 ps are indicative of what? Severe hypertension, headache, hypermetabolism, hyper sweating, hyperglycemia

Answer 37

Pheochtomocytoma (Tumor on adrenal cortex)

Question 38

Alpha Blockers, Minpres, Hytin, Beta blockers, Atenolol, Inderal LA are used for?

Answer 38

Pheochtomocytoma,

Question 39

Minpres, Hytrin do what?

Answer 39

cause periheral vasodilation

Question 40

Inderal LA does what?

Answer 40

slows heart rate and blocks norepinephrine