Med Nursing 4

Question 1

Dementia

Answer 1

A collection of symptoms caused by various diseases affecting the brain
Includes 4 types
- Alzheimer’s disease (63%)
- Vascular dementia (20%)
- Dementia with Lewy bodies (5%)
- Frontotemporal dementia (5%)

Question 2

Alzheimer’s disease

Answer 2

• Chronic, progressive, degenerative disease of the brain
• Amyloid plaques + Neurofibrillary tangles

Question 3

Parkinson’s Disease

Answer 3

• Disease of basal ganglia
• degeneration of dopamine-producing neurons in substantia nigra of the midbrain

Symptoms:
* Slowing down in the initiation and execution of movement
* ↑ muscle tone
* Tremor at rest
* Impaired postural reflexes
* Impaired physical mobility
* Imbalanced nutrition: less than body requirements
* Impaired verbal communication
* Impaired swallowing

Question 4

Osteoarthritis (OA)

Answer 4

• Slowly progressive noninflammatory disorder of the diarthrodial joints
  cartilage damage that triggers a metabolic response at level of chondrocytes
• Cartilage becomes less elastic and less able to resist wear.
• Frequent complaints of clients with OA include pain, stiffness, limitation of function, frustration

Question 5

Rheumatoid Arthritis (RA)

Answer 5

• Chronic, systemic autoimmune disease
• Nonspecific manifestations such as fatigue, anorexia, weight loss, and generalized stiffness may precede the onset of arthritic complaints.

Question 6

Gout

Answer 6

Characterized by the accumulation of uric acid crystals in one or more joints

Question 7

Diabetes

Answer 7

Abnormal insulin production
Impaired insulin utilization

Question 8

Normal glucose range

Answer 8

4–7 mmol/L
3.9-5.6 mmol/L fasting

Question 9

What happens when:
- glucose levels increase?
- glucose levels decrease?

Answer 9

• When glucose levels increase, insulin is released by beta cells in the islets of Langerhans in the pancreas.
• High blood glucose –> Pancreas releases insulin –> Cells take up glucose from blood + Liver produces glycogen –> Blood glucose falls
• When glucose levels decrease then glucagon is released by the alpha cells in the islets of Langerhans in the pancreas.
• Low Blood glucose –> Pancreas releases glucagon –> Liver breaks down glycogen –> Blood glucose rises

Question 10

Insulin

Answer 10

• Promotes glucose transport from bloodstream across cell membrane to cytoplasm of cell
• Decreases glucose in the bloodstream
• Stimulates storage of glucose as glycogen in liver and muscle
• Inhibits gluconeogenesis
• Enhances fat deposition
• ↑ protein synthesis

Question 11

Prediabetes

Answer 11

• Individuals already at risk for diabetes
• Blood glucose high but not high enough to be diagnosed as having diabetes
• 6.1–6.9mmol/L for impaired fasting glucose
• 7.1–11mmol/L for impaired glucose tolerance

Question 12

Diabetes Mellitus – Type 1

Answer 12

• Progressive destruction of pancreatic  cells by body’s own T cells
• Manifestations develop when pancreas can no longer produce insulin.
• Rapid onset of symptoms
• Present at ED with ketoacidosis

Question 13

Diabetes Mellitus – Type 2

Answer 13

• Pancreas continues to produce some endogenous (self-made) insulin.
• Insulin produced is insufficient or is poorly utilized by tissues.
• Insulin resistance
• Pancreas has decreased ability to produce insulin
• Gradual onset
• Person may go many years with undetected hyperglycemia

Question 14

Gestational Diabetes

Answer 14

• Develops during pregnancy
• Detected at 24–28 weeks of gestation
• Blood draw to test fasting glucose
• Usually normal glucose levels at 6 weeks postpartum

Question 15

Diabetes insipidus

Answer 15

deficiency in production of ADH or decreased renal response. Increased thirst (polydipsia) and polyuria. Sever dehydration and hypovolemic shock happen bc Urine output is so great that person can’t keep up with liquid intake

Question 16

HYPOGLYCEMIA

Answer 16

Progresses rapidly
fast heartbeat.
Shaking.
Sweating.
Nervousness or anxiety.
Irritability or confusion.
Dizziness.
Hunger.

Can mimic alcohol intoxication
Confusion, tremors, hunger, diaphoresis
Coma, seizures, death,

Question 17

HYPERGLYCEMIA

Answer 17

Progresses slowly
Increased thirst
Increased urine output
Decreased appetite
Excessive fatigue

Question 18

Diabetic ketoacidosis (DKA)

Answer 18

• fats are metabolized in the absence of insulin. Caused by deficiency of insulin characterized by hyperglycemia, dehydration, metabolic acidosis
• 3 p’s, tachycardia, dehydration signs, Sweet fruity odour
• Known as diabetic coma
• Laboratory findings include a blood glucose level >14 mmol/L, arterial blood pH <7.35, serum bicarbonate level <15 mmol/
• Electrolyte imbalance occurs

Question 19

Hyperosmolar hyperglycemic syndrome (HHS)

Answer 19

• can produce enough insulin to not have DKA but not enough to avoid hyperglycemia. Has extracellular fluid depletion
• Life-threatening syndrome
• Less common than DKA
• Often occurs in older clients with type 2 DM