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definition of Diabetes mellitus DM?a complex disorder of carbohydrate, fat, and protein metabolism caused by deficiency or absence of insulin secretion by the beta cells of pancreas or by defects of the insulin receptors
classic signs and symptoms of Diabetes:1.Elevated blood sugar (hyperglicemia), 2.Elevated sugar in urine (glycosuria), 3.Excessive excretion of urine (polyuria), 4.Excessive thirst (polidipsia), 5.Excessive hunger (polyphaisa)6. Weight gain, 7.Fatigue
Type I Diabetesinsulin dependent
onset of Type I Diabetesabrupt oneset iof symptoms in the age of puberty, juwenile
what is the etiology of DM?acuired, familial, idiopathic, neurogenic, nephrogenic, possible viral, and genetic
characteristic of IDDMdecrease in size and number of islet cells resulting inadequate prodution of insulin
what is the patient that had IDDM prone to?ketoacidosis
What is type II DM?noninsulin-dependent
what is the age of diagnosis with NIDDMmaturity, adolescent, over the age of 40
what is the onset of NIDDM?gradual
What is the Impaired Glucose Tolerance?assymptomatic or borderline diabetes with abnormal response to oral glucose test. many peole will convert to type II DM within 10 years
what is the Gestational DM?glucose intolerance associated with pregnancy, in III trimester
possible causes of HYPOGLYCEMIA:failure to eat after taking insulin, excessive insulin, precipitated by exerciseing
what is a hypoglycemia?low blood sugar, <60 mg/dL
what is a hyperglycemiahigh blood sugar ,>250 mg/dL
CNS changes with Hypoglycemia?libile, irritable, headache, blurred vision, slured speech, difficulty concentrating, confusion, incoordination
what are the sympathetic changes with hypoglycemia?diaphoresis, pallor, pillow erection, tachycardia, heart palpitation, nervousness, irritability, weakness, shekiness, trembling, hunger
what is a hypoglycemic coma?a loss of conciousness taht results from an abnormal low sugar in the blood
what to do when patient has signs of hypoglycemia?give sugar, candy, orange juice
what is the onset of hyperglycemia?gradual ( days)
what are the CNS signs in hyperglycemia?dulled sense, confused, diminished reflexes, parasthesias,
sympathetic signs of hyperglycemia?thurst, flushed ( signs of dehydration), nausa, vomiting, abdomianl pain, deep, rapid respiration,pulse is rapid and weak, fruity odor to the breath, weakness,
what is a hyperglycemic coma?a diabetic coma caused by hyperosmolarity of extracellular fluid and dehydration, can lead to death,
what is the hollmark of DMfrequent urination and increased thirst
when not to exercise patient after insulin injection?between 2-4 hours after insulin injection
what is the best time to exercise Pt with DM?1 hour after meal
proper foot care in DM?wash feet daily in warm water, apply petroleum jely or lotion, clean white socks should be worn, with minimal wrinkles and wide.
what to do if glucose level is < 70 mg/dL?a carbohydrate snack or juice should be give to PT, and the level checked again in 15 min.
what to do if glucose level. 250 mg/dL?pt should not exercise
what to do if glucose between 70- 100 mg/dL?food should be given if symptoms for hypoglycemia are present
what are the secundary effects of DM?kidney failure, atherosclerosis, neropathies, infections, retinopathy, cardiac complications,
what are the tests for DM?fasting plasma glucose test, urine analisis