Test + Quiz 1 Flashcards
What is pathophysiology
The study of functional or physiologic changes in the body that result from disease processes
In what form is glucose stored when not required by the body? where is it stored?
Glycogen, polysaccharide glucose molecule in liver and skeletal muscle
What is the term for breaking down stored glucose to make it available for use
glycogenolysis
What is the process of making new glucose from fats and proteins called
gluconeogenasis
List three functions of insulin
Promotes glucose uptake and use by cells. Promotes storage of excess glucose as glycogen in liver. promotes storage of fat. increases protein synthesis.
Name three hormones that oppose the action of insulin
epinephrine(raises glucose when its needed during exercise) Growth hormone (when growing) Glucocorticoids (prolonged stress)
Describe Type 1 diabetes
Childhood onset. acute onset. autoimmune destruction genetics. low weight and lose weight. low to none plasma insulin levels. treatment is to give insulin
Describe Type 2 diabetes
40 age plus onset. slow insidious. etiology= lifestyle, environment, diet, exercise, genetics. higher then normal body weight. Low to normal plasma insulin levels. Treatment is lifestyle changes and occasional medication.
Describe Hypoglycemia?
onset is sudden. Blood glucose levels are below 4 mmol/L. Fatigue, weakness, slurred words headache, loss of conciseness. breathing normal to rapid shallow.. hunger and nausea. skin is pale, moist and cool. Tachycardia.
Describe hyperglycemia?
onset is gradual(hours or days). BG levels above 11. drowsiness and dim vision. breaths are deep and rapid with the smell of acidosis. Thirst, nausea, vomiting, loss of appetite, increased urination. dry, flushed and warm skin. Tachycardia and week.
What is the normal fasting serum glucose level?
more then 4 mmol/L and less then 7 mmol/L
Name 4 test results that would allow for diagnosis of diabetes?
- Fasting Plasma Glucose (FPG)- 8 hour fast
- Random plasma Glucose(RPG)- no fast
- Oral Glucose tolerance test (OGTT)- pregnancy
- Glycosylated Hemoglobin test (HgbAIC) one shot testing to see how much glucose is bonded to red blood cells.
clients only need to meet 3 but list 5 criteria for a diagnosis of metabolic syndrome
- abdominal obesity
- elevated theyrocids. LDL
- hypertension
- Low HDL’s (high density lipoprotein, cholesterol)
- FBG 5.7- 7.0 mmol/L
58 year old makes insulin int he pancreas but he cells are resistant to its effect. Type 1 or type 2?
Type 2
What is the only treatment for type 1 diabetes?
insulin
Discuss the reason that clients with diabetes have increased urine outputs
Causes diabetic diuresis, when glucose levels are so high that the glucose is exerted int he urine followed by the water content passively.
Define the three polys
Polyuria- frequent urination
polydipsia- excessive thirst
polyphagia- excessive hunger
the term that describes the water loss from the kidneys that occurs in diabetes
osmotic
how does stress or illness effect diabetes?
stress aggravates diabetes, raises blood sugar levels, activates fat cells, increases insulin resistance.
Explain DKA
Diabetic ketoacidosis. insulin deficiency leads to inhibition of transfer of glucose into cells. glucose levels are high. affects type 1 diabetes. breakdown of fats. sudden onset. ketones present. Blood pH above 7.3. osmolatrity above 350nmOsmol/L as it increases with dehydration. acidosis is present.
Explain HHNK
hyperosmolar hyperglycaemic state. Type two diabetes usually older patients. slow insidious onset. glucose levels are extremely high. no ketone production and no break down of fats. pH is normal. higher rate of mortality.
List 3 treatment interventions for DKA
Restore circulatory volume.
Decrease serum glucose levels
correct acidosis
restore electrolytes to normal
List 3 treatment interventions for HHNK
Fluid restoration
Correct electrolyte imbalance
Admin of insulin IV
Macroangiopathy
obstruction Arteries and arterioles (atherosclerosis) Manifestations incluse CVA, PVD, MI and diabetic ulcers.
Retinopathy (micro)
Pathological changes occur in the capillaries of the retina. Vision loss develops 10 years after onset of diabetes.
Nephropathy (micro)
chronic renal failure of the kidneys. Impaired filtration of blood during urine formation. Kidney failure, 10-15 years after onset for complications to start to appear.
Sensory neuropathy
effects both myelinated and non-myelinated nerves. ability to feel strange sensations. feet and hands most effected. Infection falls and injury.
Automatic Neuropathy
effects automatic nerve systems. Automatic functions such as heart rate, blood pressure, bowel, bladder and digestion functions.
Explain why diabetic clients are predisposed to infection and poor wound healing
Limbs don’t get enough blood flow plus lack of sensation therefor patients don’t feel when they hurt themselves. Lack of blood flow= slower healing rate and microorganisms thrive in high glucose levels.
atherosclerosis
Narrowing of large arteries by cholesterol plaque and thrombosis
paresthesia
Abnormal sensation of the skin with no apparent physical cause
hyperesthesia
when a non-painful stimulus causes the sensation of pain in the area
gastroparesis
in which the stomach can not empty its food in a normal fashion
describe Metiformin (glucophage)
First line of defense for persons diagnosed with type 2 diabetes. reduces hepatic glucose production and increases insulin sensitivity. no risks. decreases risk of cardio problems. some minor GI symptoms. No alcohol and not to be used during a die test.
