314 Exam 3 Flashcards by Stephen Nicewarner

⬇️ with ⬆️ adipose

Regulates insulin sensitivity

Adiponectin

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High levels of leptin lead to…

Overeating/hyperphagia

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Name two proteins associated with insulin resistance

Leptin

Adiponectin

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This protein expressed by adipocytes acts on the hypothalamus and is involved in satiety/appetite

Leprin

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5 coexisting metabolic syndrome patholoies

Abdominal obesity

Insulin resistance

Hyperglycemia

Hyperlipidemia

Hypertension

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Obesity neurological effects

Stroke

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Obesity cardiovascular effects

Many heart and vascular diseases

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Obesity respiratory effects

Sleep apnea

Decreased ventilation

Pneumonia

Asthma

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Obesity orthopedic affects

Joints

Immobility

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Obesity gastrointestinal affects

Nonalcoholic fatty liver disease

Liver cancer

Gallstones

GERD

Abdominal hernia

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Obesity integumentary effects

Infection

Wounds

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Obesity Genitourinary effects

Infertility 
Low testosterone 
Kidney stones 
BPH
prostate cancer 
Erectile dysfunction 
PCOS

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Obesity cancers

Breast

Endometrial

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Childhood obesity treatment

Include all family and caregivers

Begin early-when family is ready

Educate family to monitor eating

Well balanced meals

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Immobility ⬇️

Circulating neurotransmitters ⬇️ mood, interest, socializing.

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Effects of immobility, cardiovascular

⬆️cardiac work load
⬆️risk for orthostatic hypotension
⬆️risk for venous thrombosis

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Affects of immobility, respiratory

⬇️depth of Respiration
⬇️rate of respiration
Pooling of secretions
Impaired gas exchange

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Nursing Interventions combating immobility respiratory problems

Incentive spirometry

Breathe in nose, out mouth

Turn patient

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Effects of immobility, gastrointestinal

Disturbance in appetite

Altered protein metabolism

Altered digestion and utilization of nutrients

Decreased peristalsis

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Immobility effects, Urinary

⬆️Urinary stasis
⬆️Risk for renal calculi
⬇️bladder muscle tone

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Effects of immobility, musculoskeletal

⬇️muscle size tone strength
⬇️ joint mobility
Bone demineralization
⬇️endurance 
⬆️contracture risk

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Effects of immobility, metabolic

⬆️risk for electrolytes imbalance

Altered exchange of nutrients and gases

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Effects of immobility, integumentary

⬆️ risk for skin breakdown/pressure ulcers

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Beginner exercise

Walking 10 minutes/3 times/week

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Adult Aerobic

2.5 hours each week, at leas 10 minutes each time

Strengthening

2 days a week

Non beginners

5 hours/week Increase effort

Five or six out of 10 is…

Moderate intensity

Seven or eight out of 10 is…

Vigorous intensity

What does DASH diet stand for?

Dietary approach to stop hypertension

NIH research shows that the dash is also good for…

Weight loss

The dash diet cuts…

Added sugars Refined grains Processed foods

Glycogenolysis

Liver converts glycogen to glucose

Hormone that causes glycogenolysis

Glucagon

Gluconeogenesis

Liver creates new glucose

Type of fat found in the blood

Triglyceride

Almost all body cells can use fatty acids interchangeably with glucose for energy except…

Brain Nervous system RBCs

The liver uses a small amount of fatty acids for its own energy needs and converts the rest into…

Ketones

These ketones are released into the…

Blood stream

Amylin Somatostatin Gut derived hormones Conterregulatory Also regulate...

Glucose

4 cell types of Islet of Langerhans:

Alpha Beta Delta F/PP

Alpha cells secrete...

Glucagon

Beta cells secrete...

Insulin

Delta cells secrete...

Somatostatin

F/PP cells secrete...

Hormone of unknown function (pancreatic polypeptide)

Acini secrete

Digestive juices into duodenum

True or false: Insulin increases protein synthesis

True

Increases transport of aa into the liver

Glucagon

Inhibits gastric emptying and glucagon secretion

Amylin

Inhibits release of glucagon and insulin

Somatostatin

Gut derived hormones

Increased insulin secretion after oral nutrient load (incretin effect).

Stimulate glycogenolysis in liver Inhibit insulin release, decreases movement of glucose into muscle cells Increases breakdown of muscle glycogen stores

Catecholamines such as epinephrine

Increases protein synthesis in all cells of the body mobilizes fatty acids from adipose cells Antagonizes effects of insulin

Growth Hormone

Stimulates gluconeogenesis Decreases tissue use of glucose

Glucocorticoid hormones

Normal glucose levels

70-110 mg/dL

Name 4 types of diabetes

Type 1A Type 1B Type 2 Gestational diabetes

Prediabetes FPG range (IFG)

100-125 mg/dL

Prediabetes OGTT range (IGT)

140-199mg/dL

Prediabetes A1C

5.7-6.4%

How many hours before FPG?

Involves continuous glucose monitoring via catheter implanted into SQ tissue

Capillary blood glucose (CBG) monitoring

Index of glucose level for 6 to 12 weeks/2 to 3 months

Glycosolated Hemoglobin

Autoimmune beta cell destruction

Unknown cause of beta cell destruction and higher frequency of DKA

Condition when fatty acids released from liver and converted to ketones

DKA

Insulin treatment is required for all

Type 1A diabetes

Increased gluconeogenesis is associated with what type of diabetes?

Type 2

Theory for insulin resistance in obese people

Insulin resistance in obese people caused by increased concentrations of FFA's

FFA's inhibit

Glucose uptake

Risk for Gestational diabetes

``` Fhx of type 2 diabetes Glucosuria Obesity PCOS Hx GDM Infant large for age ```

Endocrine disorders linked to diabetes

Acromegaly Cushing syndrome Pheochromocytoma

Diuretics can impair beta cell function by

Increasing potassium loss

Diabetes causes polyphagia because

Glucose isn't entering cells effectively

Causes of hypoglycemia

Too much insulin Failure to eat Increased exercise Medication changes

Ethanol decreases

Gluconeogenesis

Extreme symptoms of hypoglycemia

Coma Seizure

Stimulate insulin at the level of the pancreatic beta cells

Insulin secretagogues

Inhibits hepatic glucose production and increases sensitivity of insulin

Biguanides

Block the action of intestinal brush border enzymes that break down complex carbohydrates

X-glucosidase inhibitors

Only class of drugs that directly target insulin resistance

Thiazolidinedones

Hormones released into the circulation by the G.I. tract after a meal. They amplify glucose induced release of insulin

SGLT2 inhibitors

Biguanide contraindications

Elevated serum creatine Liver disease Hypoxemia Dehydration

Alpha glucosidase can cause hypoglycemia when combined with

Sulfronylureas

Thiazolidinedone contraindications

Class III/IV heart failure Bone fracture risk

4 things that lead to diagnosis of DKA

Glucose >250 Low serum bicarbonate Low arterial pH Urine and serum ketones

Weird thing about DKA

Fruity smell

DKA treatment

Hydration Insulin Electrolyte replacement

HHS has hyperglycemia >

600

HHS treatment

Hydration Potassium replacement

Which is more severe, HHS OR DKA?

HHS

Angiotensin II raises arterial pressure via

Aldosterone Sodium retention Vasoconstriction

Parasympathetic to heart via

Vagus Nerve

Sympathetic to heart via

Spinal cord and peripheral nerves

314 Exam 3 Flashcards

(93 cards)