Exam 9: Endocrine, Gastrointestinal, Elimination, Immunologic Flashcards
(75 cards)
1
Q
diabetes mellitus (DM)
A
- metabolic condition
- chronic
- impairment of production and or use of insulin
- deficiency of or reduced sensitivity to insulin
- insulin is required for cellular uptake of glucose
2
Q
insulin
A
- produced by islet cells in the pancreas
- manages and regulates glucose in blood; transports glucose from blood cells
3
Q
glucose (too much/ little/ just right)
A
- too much: crystalize blood vessels and causes them to break (small ones first), more common in type II, damages blood vessels, kidneys, liver, eyes, nerves, etc.
- too little: damage heart, brain, and other tissues/organs
- perfect amount: energizes, mentally sharp, protects from starvation, produces protein needed for muscles
4
Q
type I
A
- body doesn’t produce enough insulin bc…
- autoimmune factors: body attacks and destroys pancreatic cells needed for production
- NOT caused by overconsumption of glucose
- early onset
- requires insulin replacement
- injections, shots, glucometer (monitor levels)
5
Q
signs & symptoms (type I)
A
- polyuria
- polydipsia
- polyphagia
- anorexia = weight loss
- increased fatigue
- diaphoresis
- hyperglycemia
- muscle cramps
- digestion problems
- chest pain
- nausea
- irritability
- blurred vision
6
Q
type II
A
- adult onset
- initially may not need insulin
- excessive glucose in blood over time due to diet, genetics, age
- pancreas wears out and makes less insulin OR tissues become resistant to insulin
7
Q
type II risk factors
A
- prevalent in African Americans, Latinos, Native Americans
- high sugar and fat in diet
- sedentary lifestyle increases risk
- equal between men and women
- dramatic increase from 1980-2012
- obesity
8
Q
signs & symptoms (type II)
A
- polyuria
- polydipsia
- polyphagia
- unusual weight loss
- extreme weakness/ fatigue
- frequent bladder infections
- cuts/ bruises that are slow to heal
- numbness/ tingling in hands or feet
9
Q
gestational diabetes
A
- temporary type II while pregnant
- increases risk for developing diabetes later
- baby grows too large, can struggle managing blood glucose levels post-birth
10
Q
four types of blood tests
A
- hemoglobin a-glycated: shows glucose levels for 3 mo period (A3C)
- fasting plasma glucose: checked after a fast followed by 2 hr glucose intake
- random plasma glucose
- check for type I with presence of pancreatic antibodies
11
Q
risks of DM
A
- diabetic retinopathy
- cardiac, cerebral, and peripheral vascular disease
- damages structures due to excessive glucose
12
Q
hyperglycemia 1
A
- too little insulin causing abnormally high blood glucose levels
- thirst
- heartburn
- fast and deep breathing
- headache, nausea
- abdominal pain
- blurred vision
- ketoacidosis: untreated can lead to diabetic coma; life threatening
13
Q
hypoglycemia 1
A
- insulin shock
- too much insulin and/or not enough glucose in the bloodstream
- fatigue
- headache
- drowsiness
- shallow breathing
- nausea
- need sugar, then complex carb afterwards
14
Q
diabetic neuropathy
A
- 2/3 affected
- cells don’t like having too much sugar
- nerve & tissue cells
- damage to cells
- lack of sensation, pain
- symptoms
- numbness/ tingling in hands/ feet
- intrinsic muscle atrophy in hands/feet
15
Q
diabetic vascular damage
A
- cause of 60% non-traumatic limb amputations
- foot ulcers, heal slowly, may lead to gangrene
- slow healing wounds
- chronic neuropathy
- poor peripheral circulation
- loss of sensation
- lead to LE amputations
16
Q
technology & diabetes
A
- insulin pumps
- blood glucose monitoring
17
Q
normal blood sugar
A
fasting blood sugar
- normal with DM is 100-125
- considered pre-diabetic otherwise
- normal without DM is 80-100
- random blood sugar test
- less than 200 mg/dl
18
Q
impact of DM on occupational performance
A
- cognition
- lifestyle choices, psychosocial
- (ADLs) eating, mobility, personal hygiene, dental care, foot care, skin inspection, sexual functioning
- (IADLs) home management, meal prep, tasks that require cognition due to fluctuations in glucose levels
- vision, sleep, nocturia, etc.
19
Q
role of OT in DM
A
- not treating the disease, but the effects or management of the symptoms and disease course
- education
- chronic disease management
- lifestyle changes: habits, routine, rituals
- compensatory techniques, prosthetic training
- IADL of glucose checks and insulin injection (routine, not doses)
- low vision adaptations
20
Q
hypoglycemic/ia
A
low blood glucose
21
Q
hyperglycemic/ia
A
high blood glucose
22
Q
tachycardia
A
high heart rate (100+)
23
Q
dehydration
A
loss of fluid is greater than intake of fluid
24
Q
polyuria
A
increased frequency of urination
25
polydipsia
excessive thirst
26
diaphoresis
increased sweating
27
peripheral neuropathy
abnormal sensations in extremities due to damage of cells
28
hypertension
high blood pressure
29
hyperlipidemia
high cholesterol in blood; blood has too many lipids
30
polyphagia
extreme hunger
31
bariatric
related to obesity
32
obesity
- 1 of top 10 health concerns
- diet, physical inactivity, genetics
- health disparities: environment, socioeconomic status, health literacy and access to health education
- excessive body fat
33
medical management - precautions & contraindications (obesity)
- diet & exercise
- medications to manage secondary conditions
- psychological consultation
- bariatric surgery
- cardiac/ pulmonary stress
- risk for OA
- skin integrity
- heat intolerance
- risk to practitioner (moving a patient)
34
OT role in obesity
- bariatric assistive technology: toileting, mobility, transfers
- decreased ROM to reach areas
- teach techniques for skin care
- energy conservation, pacing, exercise program
- self awareness & coping strategies
35
hypothyroidism
hashimoto's thyroiditis is autoimmune and most common type of hypothyroidism
36
hyperthyroidism
thyroid is overactive; this causes the production of too much thyroid hormone which boosts the metabolism
37
adrenal disorders
Cushing's Disease, Addison's Disease
38
Pancreatitis
- inflammation of pancreas
- causes pain after eating
39
immune system function
- protects against disease by identifying and killing pathogens
- detects wide variety of agents (viruses)
- distinguish from healthy cells in order to function properly
- protect body from foreign invaders
- sends out different types of cells to kill germs
- complex network of cells, tissues, and organs
40
germs
- neutrophils & macrophages eat and destroy germs
- phagocytosis
- germs, bacteria, viruses, parasites
41
multiple sclerosis
- autoimmune and immunologic in origin
- demyelination (CNS: sensory, motor, emotional, cognitive, etc.)
- death of nerves and scar tissue visible on MRI
- degenerative disease
42
OT intervention in MS
- PT may have exacerbations and periods of stable symptoms
- fatigue is large factor
- teach energy conservation and fall prevention techniques
- assist in coping with emotional challenges
- encourage acceptance of adaptive equipment when needed
teach safe techniques for ADL performance
- teach compensation for sensory loss
43
types of cancer
- carcinoma
- sarcoma
- chondroma
- lymphoma
- leukemia
- melanoma
44
-emia
blood
45
-oma
abnormal growth
46
neoplasms/ cancer
CA
- proliferations of abnormal cells
- malignant
- benign
- metastatic (spread)
- biopsy lymph nodes near original tumors
- cause fatigue which affects managing ADLs and IADLs
47
OT intervention with cancer
- coping strategies
- energy conservation
- task simplification
- strengthening or endurance improvement
- healing after surgery (stretching, soft tissue management)
- compensation for loss of body structures or functions
48
4 main functions of lymphatic system
1. collecting lymph from the body's interstitial spaces
2. filtering the lymph through lymph nodes
3. detecting and fighting infection in the lymph nodes
4. returning the lymph to the bloodstream
* linked to immune and cardiovascular systems
* valves to prevent backflow; skeletal muscle contractions assist with drainage
49
OT intervention/ treatment w/ lymphatic system/ lymphedema
- energy conservation
- strength training
- ADL
- adaptive equipment
- positioning
- palliative care/ comfort care
- caregiver education
50
lymphedema
- accumulation of fluid in soft tissue due to low volume insufficiency of the lymphatic system
- present in extremities, face, trunk, abdomen, and inner organs
- chronic & progressive
51
etiology of lymphedema
- might occur following the removal of a sentinel node after a mastectomy; after a CVA because skeletal muscles cannot assist with contraction & drainage in extremities
- inherited, congenital malformations present at birth or develop later in life (primary)
- result of damage to the system; result of surgery or radiation therapy (secondary)
52
lymphedema incidence
- 5% of patients will develop lymphedema in their first year following breast cancer treatment
- about 25% of patients will develop lymphedema in their lifetime
- can occur up to 30 years of treatment
- do not take bp on side where mastectomy has occurred due to risk of damaging lymph vessels or nodes
53
OT treatment lymphedema
- (MLD) manual lymphatic drainage
- mechanical lymphatic devices such as vascompresion units
- intermittent compression units
- compression bandages/ wraps
- aquatic therapy
- exercise
54
types of hepatitis
+ symptoms
- hepatitis a (HAV)
- hepatitis b (HBV)
- hepatitis c (HCV)
* jaundice: yellowing skin & eyes
55
methicillin-resistant staphylococcus aureus (MRSA/ CA-MRSA)
- staph infection that occurs most frequently in health care facilities in people who have weakened immune systems
- can cause potentially life threatening infections (bloodstream, surgical site, pneumonia)
56
transmission of MRSA
- people who already have it
- colonized (asymptomatic)
- contact with a person who has a wound infection or respiratory tract infection
- inadequate handwashing in healthcare provider can transmit it to residents
- universal standard precautions to prevent spread
57
types of TB
- latent
- active
58
latent TB
- exposed, but show no symptoms
- positive Mantoux
- typically doesn't become active
59
active TB
- active disease process
- symptomatic
60
Mantoux Test
- injection of PPD tuberculin
- if there is a visible response on skin, it is positive (redness, swelling, raised, hard)
61
if positive TB (Mantoux)
- always positive, unless a false positive
- need to have chest x-ray to prove it is not active
62
HIV/AIDS
HIV: human immunodeficiency virus
AIDS: acquired immunodeficiency syndrome
** can be HIV + and not have AIDS
63
diverticulosis & diverticulitis
bulge in the digestive tract
64
constipation & bowel obstruction
- common with pain meds, advanced age, other medications, decreased fluid and fiber intake.... can lead to
- dangerous, often requires hospitalization, patients with complex issues may be seen by OT
65
Crohn's Disease
- autoimmune
- inflammation of small intestine
- causes weight loss, pain, difficulty absorbing nutrients
66
ulcerative colitis
- involves large intestine
- causes ulcers that will bleed
67
GI bleed
- sometimes person is unaware
- can cause anemia overtime
- watch for pale skin tone, fatigue, changes in bp
68
benign prostate hypertrophy (in men)
- age related enlarged prostate
- interrupts of slows flow of urine
- can cause urinary retention where bladder never empties completely
- may cause male incontinence or UTIs
- will often be treated with TURP (transurethral resection of the prostate)
69
UTIs
- older adults may not show traditional signs of pain with urination
- confusion, falls, change in function
- caused by poor perineal hygiene/ decreased fluid intake which concentrates the urine and irritates the bladder
- will cause bladder irritation and incontinence
70
urge incontinence
- caused by bladder spasms
- treated by OT with bladder programs and timed voiding
71
stress incontinence
- caused by pelvic floor weakness
- treated by OT with pelvic floor strengthening
72
functional incontinence
- due to mobility impairments that are often temporary
- use commodes for easier access, toilet devices to decrease risk of falls
73
end stage renal disease (ESRD)
- often related to diabetes
- clients often don't urinate
- every other day dialysis
- will have a dialysis port
- must watch bp closely
- fluid intake limitations
74
renal disease
- stage I - IV
- we often work with people in ESRD
- prone to weakness, bp changes, infections, cognitive changes if toxins build up in body
75
OT interventions for renal disease
- falls prevention
- energy conservation
- task simplification
- adaptive equipment needs
- infection control
