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Health and Illness Exam #2 > Metabolism > Flashcards

Metabolism Flashcards

1
Q

The body requires?

A

A constant supply of Glucose

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2
Q

Type 1 Diabetes

A

Autoimmune dysfunction involving the destruction of beta cells
- Heredity
- No insulin at all

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3
Q

Type 2 Diabetes

A

Progressive condition due to increasing inability of cells to respond to insulin and decreased production of insulin
- Obesity, sedentary lifestyle, heredity
- Metabolic Syndrome
- Insulin resistant

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4
Q

Diagnosing Diabetes

A
  • HgbA1C over 6.5%
    AND
    Symptoms of diabetes + random serum glucose over 200
    OR
    Fasting serum glucose over 126 mg/dl
    OR
    2h serum glucose over 200 in oral glucose tolerance test
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5
Q

Hyperglycemia Symptoms

A
  • Polyuria, polydipsia, polyphagia
  • Kussmauls Respirations - remove ketones
  • Hypovolemia
  • Recurrent infections and non healing wounds
  • Skin changes
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6
Q

DKA

A
  • RAPID onset
  • Glucose over 300
  • Ketones in urine and blood
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6
Q

Acanthosis Nigricans

A

Type 2 Diabetes Sign
- Skin, neck fold

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7
Q

DKA Treatment

A
  • Monitor glucose levels
  • Fluid and electrolyte management
  • Insulin therapy
  • Acidosis management
    -Hyperkalemia than hypo
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8
Q

HHS

A
  • SLOW onset
  • Glucose over 600
  • Ketones absent
  • No acidosis
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9
Q

HHS Treatment

A
  • Fluids!!!
  • Insulin therapy
  • Monitor electrolytes
  • Hyper and hypo kalemia
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10
Q

Complications of Hypoglycemia

A

Causes: Insulin excess vs deficient food
Manifestations: Anxiety, sweating, hypoglycemia, unawareness, coma, seizures possible
Treatment: 15 g rapid acting card, dextrose ( 25-50% IV ) or Glucagon SQ, IM

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11
Q

Interventions for Diabetes

A
  • Limit trans fat, 25 g of fiber, avoid sugars
  • CHO counting, 1 unit of rapid acting insulin per 15 g CHO
  • 150 min of exercise
  • Weight loss ( 10% )
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12
Q

Osteoporosis Modifiable Risk Factors

A
  • Low bodyweight
  • Poor nutrition
  • Caffeine intake
  • Chronic low Cal, Vit D
  • High ETOH intake
  • Smoker
  • Low estrogen
  • Sedentary lifestyle
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13
Q

Osteoporosis Non-Modifiable Risk Factors

A
  • Family history
  • Age ( Over 50 )
  • Female
  • Menopause
  • Anorexia
  • Kidney/ Liver Disease
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14
Q

Osteoporosis Assessment

A
  • Reduction height of 5 to 7.5 cm ( 2-3 inch )
  • Kyphosis
  • Acute / chronic back pain
  • Restriction in movement
  • History of fractures
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15
Q

What electrolytes are involved in the development of osteoporosis?

A
  • Calcium and phosphorous
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16
Q

Labs and Diagnostics for Osteoporosis

A
  • Blood calcium , Vit D, phosphorous, ESR, alkaline phosphate
  • 24 hr urine
  • Bone turnover
  • Xray
  • DEXA Scan
  • CT/MRI
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17
Q

Osteoporosis Med Considerations

A
  • Calcium supplementation
  • **Raloxifene hydrochloride ( hormonal agent )
  • Bisphosphonates
  • Alendronate and Risedronate
  • Estrogen replacement ( ERT )
  • Premarin
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18
Q

Osteoporosis Complications

A
  • Fractures: Lead to increased risk of death within 1 year following
  • Weakening of the bones; stress fractures
  • Caused by coughing, bending over
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19
Q

Hyperthyroidism

A

Caused by excessive thyroid hormone
Risk factors: Graves, thyroiditis, toxic adenoma

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20
Q

Hyperthyroidism S/S

A
  • Weakness
  • Irritability
  • Fatigue
  • Heat intolerance
  • Frequent stools
  • Increased appetite w weight loss
  • Exophthalmus
  • Tachy
  • Tremors
21
Q

Hyperthyroidism Labs

A
  • Decreased TSH, Elevated T3 and T4
22
Q

Hyperthyroidism Intervention

A
  • Increase calories, protein
  • Reduce room temp!
  • Temp increase of 1 degree F or more notify immediately = thyroid crisis
23
Q

Hyperthyroidism Medications

A
  • Thioamides; methimazole
  • Beta blockers
  • Iodine solutions
  • Thyroidectomy
24
Q

Hyperthyroidism Complications

A
  • Thyroid Storm
    : Sudden surge of large amounts of thyroid hormone into the blood stream
  • Hypocalcemia and tetany
    : Damage to parathyroid gland causes hypocalcemia and tetany
25
Q

Hypothyroidism

A
  • Low T3 and T4
  • High TSH
26
Q

Hypothyroidism S/S

A
  • Fatigue, lethargy
  • Cold intolerance
  • Weight gain
  • Thick, brittle fingernails
  • Brady
  • Hair loss
27
Q

Hypothyroidism Interventions

A
  • Low calorie, high bulk diet
  • Levothyroxine
28
Q

Myxedema Coma

A

Life threatening condition that occurs when hypothyroidism is untreated and poorly managed.
- Resp failure
- Hypotension
- Brady
- Hyponatremia
- Hypoglycemia
- Coma

29
Q

Hepatitis

A

-Inflammation of liver cells.

30
Q

Cirrhosis

A

-Permanent scarring of the liver

31
Q

Hepatitis

A
  • Viral is the most common type
  • After exposure to virus or toxin the liver becomes enlarged
32
Q

Hep A

A
  • Prevent w vaccination! Best way to prevent Hep A!
  • Wash hands
  • IGM and IgG
  • ALT, AST, ALP, Billirubin all elevated
33
Q

Hep B

A
  • Prevent w vaccination
  • No needle sharing, safe sex, not sharing razors, toothbrushes, clean needles for tattoos
  • HBsag positive
  • ALT, AST, ALP, Billirubin all elevated
34
Q

Hep C

A
  • No vaccine
  • Contact w infected blood
  • HCV RNA
  • ALT, AST, ALP, Billirubin all elevated
35
Q

Expected findings –>

A
  • Fatigue, abdominal pain, fever, vomiting, dark colored urine, jaundice, pruritis
36
Q

Nursing Interventions for Hepatitis

A
  • High carb, high calorie, moderate fat and protein diet
  • Avoid alcohol
  • Frequent rest periods, avoid exercise
37
Q

Hepatitis Complications

A
  • Chronic Hepatitis
    : ongoing inflammation, Hep B/C
  • Fulimant Hepatits
    : Fatal, no meds, devolep in days
  • Cirrhosis
  • Liver Failure
  • Hepatic encephalopathy
38
Q

Cirrhosis

A
  • Extensive scarring of liver caused by necrotic injury or chronic reaction to inflammation over a prolonged period of time –> replaced w fibrotic tissue which lacks function
39
Q

Postnecrotic

A

Caused by viral hep, med, toxin

40
Q

Laennec’s

A

Alcohol

41
Q

Billiary

A

Biliray obstruction

42
Q

Risk factors for Cirrhosis

A
  • Alcohol use disorder
  • Chronic viral hep
  • Autoimmune hep
  • Steatohepatitis ( NASH )
  • Damage from meds, toxins
  • Severe right sided heart failure
  • Billiary cirrhosis
43
Q

S/S Cirrhosis

A
  • Fatigue
  • Weight loss, abdominal pain
  • Pritus
  • Confusion
  • GIB: esophageal varices
  • Splenomegaly
  • Ascites
  • Jaundice
  • Spider angiomas
  • Asterixis
44
Q

Assessment Cirrhosis
Labs

A

Lab: AST, ALT, ALP, bilirubin elevated, decreased blood protein, decreased albumin, decreased RBC, increased INR, increased ammonia, increase creatine

45
Q

Assessment Cirrhosis
Imaging

A
  • Abdominal ultrasound
  • CT
  • MRI
46
Q

Assessment Cirrhosis
Diagnostics

A
  • Liver biopsy
  • ERCP
47
Q

Cirrhosis Interventions

A
  • Monitor O2 levels, elevate head of the bed 30 degrees with feet elevated
  • Decrease itching w cold water and lotion
  • Daily weight
  • High carb, high protein, moderate fat and low sodium diet
  • Monitor ascites
48
Q

Cirrhosis
Responding

A
  • Diuretics ( fluid overload ) beta blockers ( esoph varices ) , lactulose to promote excretion of ammonia through stool
  • Paracentesis
  • Liver transplant
49
Q

Cirrhosis
Reflecting

A
  • Decrease or no ascites
  • Electrolytes WNL
  • No hemorrhage
  • No alchohol

Health and Illness Exam #2 (3 decks)

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