QUIZ 10

Question 1

vent

Answer 1

ventilator

Question 2

vfib

Answer 2

ventricular fibrilation

Question 3

v/o

Answer 3

verbal order

Question 4

VRE

Answer 4

vancomycin resistant enterococci

Question 5

VS

Answer 5

vital signs

Question 6

VSS

Answer 6

vital signs stable

Question 7

WBAT

Answer 7

weight bearing as tolerated

Question 8

WBC

Answer 8

white blood cell

Question 9

W/C

Answer 9

wheelchair

Question 10

WHO

Answer 10

world health organization

Question 11

WIC

Answer 11

women, infants and children

Question 12

WNL

Answer 12

within normal limits

Question 13

w/o

Answer 13

without

Question 14

X

Answer 14

times

Question 15

dawn phenomenon

Answer 15

fasting hyperglycemia without prior nocturnal hypoglycemia..
happens when growth hormone is secreted at night and patients awake with elevated fasting glucose. dawn phenom. is exaggerated in pregnancy due to additional hormones secreted at night.
inject NPH insulin at bedtime to treat; it will peak as the level of growth hormone rises.

Question 16

diabetes mellitus (DM)

Answer 16

group of metabolic disorders characterized by abnormal fuel metabolism, all of which have hyperglycemia in common. these disorders result from defects in insulin secretion, insulin action, or both.

Question 17

diabetic ketoacidosis (DKA)

Answer 17

life threatening complication from acute or relative deficiency in insulin secretion and characterized by profound disturbances in metabolism of carbs, fat, proteins.
typically treated in ICU. patient care aimed at correcting severe dehydration, insulin deficiency, metabolic acidosis from ketosis and lactic acidosis, and depletion of electrolytes from osmotic diuresis.
precipitating event must also be identified and corrected.
fruity breath
commonly happens with Type 1 diabetics, but can happen with Type 2 also

Question 18

diabetic peripheral neuropathy

Answer 18

polyneuropathy in legs, feet, hands. potentially very serious complication of diabetes. significant factor in pathway leading to lower extremity ulcers. predominantly associated with sensory loss, but motor and autonomic nerve fibers can also be affected.
s/s: numb, pain, burning, tingling, eventual partial or total loss of sensation over weeks or months. pain felt first distally, usually in lower legs and worse at night. pain can be persistent or intermittent. primary tx: pain management

Question 19

gestational diabetes mellitus (GDM)

Answer 19

onset of diabetes in pregnancy.
2-10% prevalence, can reach 10-20% in high risk populations.
risk factors: previous GDM, advanced maternal age, obesity, family hx of DM, racial/ethnic (african americans, hispanics, latinos, american indians have highest risk).
require dietary treatment, possibly oral meds or insulin therapy to control hyperglycemia.
uncontrolled hyperglycemia in pregnancy can cause fetal/maternal complications
GDM resolves after birth, however these women have 35-60% chance of developing DM in the 10-20 yrs after.

Question 20

glucosuria

Answer 20

the presence in the urine of abnormal amounts of sugar.

Question 21

hemoglobin A1c (HgA1c)

Answer 21

the Hgb A1c test is the primary lab test for monitoring long term glucose control.
A1c is formed when glucose in the blood binds irreversibly to hemoglobin to form stable glycated hemoglobin complexes. protein glycation is the nonenzymatic reaction of sugars with proteins. norm RBC life is 90-120 days. so A1c reflects the average blood glucose values of previous 2-3 months and is directly proportional to concentration of plasma glucose in blood over life span of red blood cells.

Question 22

hyperglycemia

Answer 22

high blood glucose

Question 23

hypoglycemia

Answer 23

low blood glucose

Question 24

hypoglycemic unawareness

Answer 24

loss of autonomic nervous system response to low blood glucose. symptoms like tachycardia, sweating, palpitations that normally prompt patients to eat are no longer there. results from altered counterregulation, esp deficient glucagon and epinephrine responses to hypoglycemia.
at risk for severe hypoglycemia and injury; probability of unawareness should be considered in pts with increased emphasis on normalization of BG control using intensive insulin regimens and oral hypoglycemic combo therapy

Question 25

hypersmolar hyperglycemic syndrome (HHS)

Answer 25

life threatening complication characterized by serum hyperosmolarity, dehydration, hyperglycemia. usually restricted to pts who cannot recognize thirst or express their need for water.
such pts may be the neglected, very young, very old, institutionalized, and those with mental deficiencies.
this syndrome is common in pts with excessive unreplaced fluid losses, secondary to massive glycosuric diuresis, following GI fluid losses and limited fluid intake. commonly connected with Type 2, but can happen with Type 1 diabetics also

Question 26

polyphagia

Answer 26

also known as hyperphagia, is the medical term for excessive or extreme hunger. It’s different than having an increased appetite after exercise or other physical activity. While your hunger level will return to normal after eating in those cases, polyphagia won’t go away if you eat more food.

Question 27

somogyi effect

Answer 27

fasting hyperglycemia with prior hypoglycemia
aka rebound hyperglycemia.
a pattern of undetected hypoglycemia followed by hyperglycemia.
typically happens in middle of night, can occur when too much insulin is circulating. cause is manmade: insulin or antidiabetic pills work too strongly at the wrong time.
process: hypoglycemia leads to release of glucose from liver, which leads to elevated fasting BG level. patient awakes with elevated BG.
differentiate btwn somogyi and dawns by testing BG in middle of night: if hypoglycemic in middle of night by hyperglycemic on awakening, its probs somogyi. if no hypoglycemia at night but still hyperglycemic in morning, its dawns.