Med Surg 3
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| Why can insulin not be taken orally? | it is destroyed by the gi enzymes
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| The diet needed with myxedema | High Fiber, Increase Fluids, Reduce calories
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| What does the oral hypoglycemia agent DiaBeta do? | Increases insulin production
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| What does the oral hypoglycemia agent Biguanides do? | reduces liver glucose production and improves glucose use
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| What does the oral hypoglycemia agent Metformin do? | improves glycemic control, stabilizes/decreases body weight, improves lipid profile
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| What is a problem with lipodystrophy? | Decreases absorption of insulin
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| What is the advantage of human insulin over animal? | Human cases have fewer allergies
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| Teaching instructions for self monitoring blood glucose. | Check in th emorning, wipe site, allow to dry, then stick, put blood on stick in monitor, apply bandaid to site
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| Why might a obese person develop diabetes? | Cells get clooged with fat. Sugar cannot get into cells to burn. Pancreas cannot keep up, makes an inadequate supply
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| Patients at risk for Diabetes Mellitus | Close relatives with DM, Baby over 9lbs.,Member of high risk ethnic population, gestational diabetes, obese, lazy, HTN, Lipoproteins, cholestrol level & triglycerides elevated
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| The result of diabetes mellitus | Decrease in pancreas function, where decreased or no insulin is being produced
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| Diabetes Mellitus affects? | eyes, kidneys, nervous & cv systems
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| What exercie is NOT done following removal of the thyroid? | Coughing
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| A common medication used for a nonfunctioning thyroid? | Synthroid
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| Possible injuries from parathyroid tumor | possible fractures & kidney stones
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| How to conduct a check for Chvostek's sign? | tap facial nerve, will be a spasm of facial muscle.
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| A symptom of Addison's disease | Skin bronze over knees, elbows, knuckles
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| A symptom of Pheochromocytoma | hypertension- systolic 200-300;diastolic above 150
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| Symptoms of diabetes mellitus | High bllod sugar, polyuria, polydipsia, recuurent infections, obesity, fatigue, blurred vision, parasthesia
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| What is the meaning of an elevated FBS? | common after 8 hrs., increases 126mg. this test does not say you are diabetic. it tells you if you are using glucose in the blood properly.
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| 2 hr post prandial test | Is given 2 hrs after meal, most accurate
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| Glycosylated Hemoglobin (HgB A1c) | tells glucocontrol over 3 months. Glucose ties onto tail of hgb- sugar is sticky.
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| What is called the master gland? | Pituitary
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| Why is the Pituitary gland called the master gland? | It helps regulate many functions of other glands.
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| What is acromegaly? | Hypersecretion of GH during adulthood
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| Signs & symptoms of acromegaly? | enlargement of bones & connective tissue-Big Hands, big feet, forehead, protruding jaw
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| What to look for in a simple Goiter? | difficulty swallowing
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| Prevention of a simple goiter? | Use iodine salt
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| What causes a Simple Goiter? | TH production decreases, thyroid enlarges- attempt to produce more hormone. Iodine is necessary for TH synthesis & secretion
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| What is the purpose of preoperative iodine drug therapy for a thyroidectomy? | to decrease vascularity & size of gland to reduce bleeding during surgery
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| What equipment should be on hand for the post op thyroidectomy? | Suction equipment, trach set, O2, Iv calcium gluconate
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| Diet for Hyperthyroidism? | Hi-calorie, protein, CHO,calcium
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| How many meals a day should someone with Hyperthyroidism eat? | 6 small meals a day & snacks
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| what in the diet should a person with Hyperthyroidism avoid? | High fiber, high spicy that would increase peristalsis
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| What to teach a patient with Addison's Crisis | Avoid Stress, Increase fluids, diet high in sodium and low in potassium, dont skip meals, wear medic alert braclet.
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| What causes Addison's crisis | If meds are stopped abruptly, stress, surgery, trauma
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| Functions of epinephrine & norepinephrine? | stimulation of sympathetic nervous system (alters CNS)
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| A common complaint for hypothyroidism? | Constipation
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| The primary assessment with Diabetes Insipidus | Output 5-15L/day, Wt loss, polyuria, polydyspnea look for s/s of dehydration-weak
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| The technique used with Vasopressin (DDAVP) via nasal spray? | Inhale with each spray
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| What is the technique to mix insulins in syringe? | Put air in cloudy, air in clear, draw up clear, then cloudy
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| Regular meal times are important for a diabetic why? | Prevent hypoglycemia
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| Why is it important for a diabetic to exercise and why should they also use caution when doing so? | It increases glucose used by the muscle, decreases need for insulin, Chl,triglycerides, improves circulation, caution used --- blood sugar may drop to rapidly with heavy exercise
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| What causes Diabetic Ketoacidosis? | Neglect or ignorance characterized by hyperglycemia or coma, in person with untreated type 1 diabetes, occurs with periods of eccesive physical, emotional stress, illness, or infection
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| S/S of Diabetic Ketoacidosis | Thirst, Dry mucous membranes, Hot dry skin, flushed face, n/v, poor skin turgor, looks & feels sick, sweet fruity breath odor, Kussmuals respirations.
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| The importance of personal hygiene for those with diabetes mellitus | Prevent complications- circ. problems, atherosclerosis
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| How to minimize complications for diabetics? | Good control of blood sugar, diet meds, take meds properly, go to DR., wt management
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| Difficulties for one diagnosed with Diabetic renopathy? | Hard time to take care of self, foot care, food prep, high risk for falls
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| what is the leading cause of blindness between the ages of 25-74? | Diabetic Renopathy
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| When does teaching start? | day of admission
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| Teaching selfcare to diabetics | Knowledge of all aspects, home environment, family, finances, teach insulin reactions, how to self check and self administer
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| What is responsible for producing excessive amounts of hormone cortisol. | Adrenal Cortex
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| Noral Blood Glucose Level | 80-120
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| Cushings disease has to much? | Cortisol
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| Aldostrone when is it released? | When blood volume falls tells kidneys to hold on to salt & water
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| Pheochromocytoma | benign tumor in adrenal medulla
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| Risk for Corneal Abrasions | tape eyelids shut at night, artifical tears
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| Insufficient amount of Thyroid Hormone | Hypothyroidism
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| what to check with Hypoparathyroidism? | Chvostek sign
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| Increased Parathyroid disorder | Calcium levels go from bones to blood. causing hypercalcemia also cause osteoperosis
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| What is the most common cause of Hyperthyroidism? | Graves Disease
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| Symptoms of Graves disease? | prtruding eyes (exophthalmos), upper lip retracted, pt will have excitability.
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| Necessary for proper functioning of the thyroid | Iodine
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| Increased calcium blood levels | Parathyroid
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| Secretes digestive enzymes and releases insulin and glucagon into the bloodstream | Pancreas
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| Regulates temperature, fluid volume, and growth | Hypothalamus
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| Produces Insulin | Islets of Langerhans
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| Produces hormones known as catecholamines | Adrenal medulla
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| Reduces excess calcium in the blood | Thyroid
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| A counterregulatory hormone | Ephinephrine
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| Reduces excess calcium in the blood | Thyroid
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| Results from antidiuretic hormone insufficiency | Addison's Disease
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| Stimulates the hypersecretion of growth hormone that causes acromegaly | Pituitary adenoma
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| Concentration of particles in the blood | Osmolarity
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| Caused by an excess production of antidiuretic hormone | SIADH
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| Caused by inadequate production of growth hormone | Dwarfism
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| Hyperthyroidism | Grave's Disease
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| Excessive production of thyroid hormone | Hyperthyroidism
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| Insufficient amounts of adrenal cortex hormones | Diabetes Insipidus
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| Common cause of primary hypothyroidism | Thyroiditis
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| Occurs with reduced calcium in the blood | Tetany
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| Morning rise of blood glucose after low levels at night | Somogyi effect
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| Insufficient insulin production | Type2
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| The organ that produces digestive enzymes and regulates the amount of glucose in the blood is called? | Pancreas
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| What releases inslulin into the bloodstream | islets of Langerhans
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| Glycogen is converted into glucose in a process know as | glycogenolysis
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| The loss of fluid from extracellular compartments is called | osmotic diuresis
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| The condition know as polyuria suggests that there is an excessive production of | urine
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| A type of phenomenon in which the blood sugar levels rise between 5am and 8am is called | dawn phenomenon
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| The classic three p's of diabetes mellitus are | polyuria,polydipsia,polyphagia
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