Physical health Flashcards
What are some reasons given for the poorer health outcomes for people with mental illness?
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
Define diagnostic overshadowing
When clinicians focus on symptoms of mental illness often to the determinant of other health issues rather than actual cause.
Describe metabolic syndrome
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
Describe lifestyle interventions nurses may implement to assist with the management of cardiometabolic health
advise and encourage lifestyle interventions around tobacco cessation, physical activity and healthy nutrition
outline reasons people with mental illnesses having poor diets
- 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
What triggers Type 1 Diabetes
- 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.
Type 1 diabetes/ insulin dependant diabetes
- autoimmune
- idiopathic (unknown cause)
- presents in young
- rapid onset
- insulin for life
- hallmark-ketones
Symptoms of Hyperglycemia (increased or high blood glucose)
increased thirst (polydipsia)
- increased urination (polyuria)
- blurry vision
- fatigue/ tiredness
- slow healing of cuts or wounds
- more frequent infections
- weight loss
- nausea or vomiting
Causes of hyperglycemia
- 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
Hypoglycemia (low blood glucose)
- ALWAYS A MEDICAL EMERGENCY
- consequences (sympathetic arousal, collapse, confusion, sexiure, coma, death)
- needs immediate attention
Warning signs of hypoglycemia
- perspiration
- pale
- shaking hands/ legs
- headache
- blurred vision
- palpitations
- dizziness/ drowsiness
- nervousness
- irritability
- hunger
- pins and needles mouth/ tongue
- confusion
- loss of concentration
Hypoglycemia prevention
- 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
Managing Type 1 diabetes with insulin
- 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)
Type 2 diabetes; diabetes melitus
- usually ages over 40
- family history
- gradual onset
- maybe no symptoms
- inefficient insulin
- overweight (95-99%)
- lean (up to 5%)
- other conditions present
Managing type 2 diabetes
- healthy diet
- exercise
- weight loss
- oral hypoglycemics
- BP and Lipid monitoring
