Physical Health Flashcards

1
Q

What are some reasons given for the poorer health outcomes for people with mental illness?

A

Psychotropic medication, associated with adverse effects on physical health, including weight gain and endocrine changes
symptoms e.g. negative symptoms can contribute to withdraw, isolation and increase likelihood of sedentary lifestyle

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2
Q

Define diagnostic overshadowing

A

When clinicians focus on symptoms of mental illness often to the determinant of other health issues rather than actual cause.

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3
Q

Describe metabolic syndrome

A

Is a cluster of abnormal clinical and metabolic findings that result in an increased risk of developing type 2 diabetes mellitus cardiovascular disease and CVD mortality

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4
Q

Describe lifestyle interventions nurses may implement to assist with the management of cardiometabolic health

A

advise and encourage lifestyle interventions around tobacco cessation, physical activity and healthy nutrition

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5
Q

outline reasons people with mental illnesses having poor diets

A
  • medications can affect hormone ghrelin and leptin which regulate hunger
  • constant craving for sugar, processed oily food, low food preparation skills, low motivation restricted budget provides mix of weight gain/poor metabolic health
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6
Q

What triggers Type 1 Diabetes

A
  • vast majority is caused by the autoimmune destruction of the pancreatic beta cells, which results in the inability to produce insulin
  • the immune system mistakenly identifies these cells as foreign and attack and destroys them.
  • born with genetic susceptibility to it?
  • an environmental trigger such as a virus or a toxin activates this genetic susceptibility to bring on the immune response
  • genetic and environmental influences leading to autoimmune destruction of beta cells.
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7
Q

Type 1 diabetes/ insulin dependant diabetes

A
  • autoimmune
  • idiopathic (unknown cause)
  • presents in young
  • rapid onset
  • insulin for life
  • hallmark-ketones
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8
Q

Symptoms of Hyperglycemia (increased or high blood glucose)

A
  • increased thirst (polydipsia)
  • increased urination (polyuria)
  • blurry vision
  • fatigue/ tiredness
  • slow healing of cuts or wounds
  • more frequent infections
  • weight loss
  • nausea or vomiting
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9
Q

Causes of hyperglycemia

A
  • insufficient insulin use or oral diabetes medication use
  • not injecting insulin properly or using expired insulin
  • diet
  • being inactive
  • illness or infection
  • certain medications e.g. steroids or beta blockers
  • injury or surgery
  • experiencing emotional stress, such as family conflict or workplace challenges
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10
Q

Hypoglycemia (low blood glucose)

A
  • ALWAYS A MEDICAL EMERGENCY
  • consequences (sympathetic arousal, collapse, confusion, sexiure, coma, death)
  • needs immediate attention
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11
Q

Warning signs of hypoglycemia

A
  • perspiration
  • pale
  • shaking hands/ legs
  • headache
  • blurred vision
  • palpitations
  • dizziness/ drowsiness
  • nervousness
  • irritability
  • hunger
  • pins and needles mouth/ tongue
  • confusion
  • loss of concentration
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12
Q

Hypoglycemia prevention

A
  • frequent BSL monitoring
  • monitor and encourage food intake
  • anticipate changes in insulin requirements e.g. fasting, changing in activity
  • give dextrose with insulin infusion (hospital)
  • educate about symptoms of hypoglycemia and encourage them to report these promptly
  • ask patient on insulin about their experience of hypoglycemia and awareness threshold
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13
Q

Managing Type 1 diabetes with insulin

A
  • Many forms of insulin, classified on how fast they work and how long they last
  • short acting e.g., Neutral (actrapid, Humulin R)
  • intermediate acting e.g., Isophane (Humulin NPH, Protaphane)
  • long acting e.g., Glargine (lantus)
  • fast acting e.g., Aspart (NovoRapid), Lispro (humalog)
  • Pre-Mixed (insulin lispro/ insulin lispro protamine (humalog mix 25, humalog mix 50)
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14
Q

Type 2 diabetes; diabetes melitus

A
  • usually ages over 40
  • family history
  • gradual onset
  • maybe no symptoms
  • inefficient insulin
  • overweight (95-99%)
  • lean (up to 5%)
  • other conditions present
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15
Q

Managing type 2 diabetes

A
  • healthy diet
  • exercise
  • weight loss
  • oral hypoglycemics
  • BP and Lipid monitoring
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16
Q

insulin resistance

A
  • the effect fat has on blocking available insulins ability to work properly
  • fat blocks insulins ability to work effectively and efficiently
  • high levels of insulin (which can not work properly) called insulinaenemia
  • muti. faceted complicated mechanism/ and is a feature of the “metabolic syndrome”
17
Q

Type 2 diabetic medications

A

Hypoglycemic agents- Biguanides, Metformin (reduces glucose prodn in liver)
Sulfonylureas- glipizide, glibenclamide, gliclazide (stimulates pancreas to release more insulin)
Alpha-glucosidase inhibitors- acarbose (slows the digestion and absorption of carbohydrates)
Thiazolidinediones- pioglitazone (increases body tissues sensitivity to insulin

18
Q

Schizophrenia, Depression and Bipolar disorder and Diabetes

A
  • 1-3 increase overall motility rate compared to normal population
  • attributes of CVD factors
  • 75% die of natural causes
  • loose 25 yrs of life r/t CVD not suicide
  • undertreated CVD risk factors
  • schizophrenia; inc intra-abdominal fat
  • Chronic elevation stress hormones
  • por physical health
  • socio-economic factors
  • genetics
  • low birth weight
19
Q

metabolic syndrome

A

Defined as 3 or more of the following

  • abdominal or visceral obesity
  • high triglycerides (ugly cholesterol)
  • low HDL (good cholesterol)
  • high BP >130/80
  • high fasting blood glucose
  • presence of MS another may to identify increased CVD risk and DM risk
  • prevalence greater for people with SMI 2-3 fold or 50%