Metabolism Flashcards
(50 cards)
1
Q
The body requires?
A
A constant supply of Glucose
2
Q
Type 1 Diabetes
A
Autoimmune dysfunction involving the destruction of beta cells
- Heredity
- No insulin at all
3
Q
Type 2 Diabetes
A
Progressive condition due to increasing inability of cells to respond to insulin and decreased production of insulin
- Obesity, sedentary lifestyle, heredity
- Metabolic Syndrome
- Insulin resistant
4
Q
Diagnosing Diabetes
A
- HgbA1C over 6.5%
AND
Symptoms of diabetes + random serum glucose over 200
OR
Fasting serum glucose over 126 mg/dl
OR
2h serum glucose over 200 in oral glucose tolerance test
5
Q
Hyperglycemia Symptoms
A
- Polyuria, polydipsia, polyphagia
- Kussmauls Respirations - remove ketones
- Hypovolemia
- Recurrent infections and non healing wounds
- Skin changes
6
Q
DKA
A
- RAPID onset
- Glucose over 300
- Ketones in urine and blood
6
Q
Acanthosis Nigricans
A
Type 2 Diabetes Sign
- Skin, neck fold
7
Q
DKA Treatment
A
- Monitor glucose levels
- Fluid and electrolyte management
- Insulin therapy
- Acidosis management
-Hyperkalemia than hypo
8
Q
HHS
A
- SLOW onset
- Glucose over 600
- Ketones absent
- No acidosis
9
Q
HHS Treatment
A
- Fluids!!!
- Insulin therapy
- Monitor electrolytes
- Hyper and hypo kalemia
10
Q
Complications of Hypoglycemia
A
Causes: Insulin excess vs deficient food
Manifestations: Anxiety, sweating, hypoglycemia, unawareness, coma, seizures possible
Treatment: 15 g rapid acting card, dextrose ( 25-50% IV ) or Glucagon SQ, IM
11
Q
Interventions for Diabetes
A
- Limit trans fat, 25 g of fiber, avoid sugars
- CHO counting, 1 unit of rapid acting insulin per 15 g CHO
- 150 min of exercise
- Weight loss ( 10% )
12
Q
Osteoporosis Modifiable Risk Factors
A
- Low bodyweight
- Poor nutrition
- Caffeine intake
- Chronic low Cal, Vit D
- High ETOH intake
- Smoker
- Low estrogen
- Sedentary lifestyle
13
Q
Osteoporosis Non-Modifiable Risk Factors
A
- Family history
- Age ( Over 50 )
- Female
- Menopause
- Anorexia
- Kidney/ Liver Disease
14
Q
Osteoporosis Assessment
A
- Reduction height of 5 to 7.5 cm ( 2-3 inch )
- Kyphosis
- Acute / chronic back pain
- Restriction in movement
- History of fractures
15
Q
What electrolytes are involved in the development of osteoporosis?
A
- Calcium and phosphorous
16
Q
Labs and Diagnostics for Osteoporosis
A
- Blood calcium , Vit D, phosphorous, ESR, alkaline phosphate
- 24 hr urine
- Bone turnover
- Xray
- DEXA Scan
- CT/MRI
17
Q
Osteoporosis Med Considerations
A
- Calcium supplementation
- **Raloxifene hydrochloride ( hormonal agent )
- Bisphosphonates
- Alendronate and Risedronate
- Estrogen replacement ( ERT )
- Premarin
18
Q
Osteoporosis Complications
A
- Fractures: Lead to increased risk of death within 1 year following
- Weakening of the bones; stress fractures
- Caused by coughing, bending over
19
Q
Hyperthyroidism
A
Caused by excessive thyroid hormone
Risk factors: Graves, thyroiditis, toxic adenoma
20
Q
Hyperthyroidism S/S
A
- Weakness
- Irritability
- Fatigue
- Heat intolerance
- Frequent stools
- Increased appetite w weight loss
- Exophthalmus
- Tachy
- Tremors
21
Q
Hyperthyroidism Labs
A
- Decreased TSH, Elevated T3 and T4
22
Q
Hyperthyroidism Intervention
A
- Increase calories, protein
- Reduce room temp!
- Temp increase of 1 degree F or more notify immediately = thyroid crisis
23
Q
Hyperthyroidism Medications
A
- Thioamides; methimazole
- Beta blockers
- Iodine solutions
- Thyroidectomy
24
Hyperthyroidism Complications
- Thyroid Storm
: Sudden surge of large amounts of thyroid hormone into the blood stream
- Hypocalcemia and tetany
: Damage to parathyroid gland causes hypocalcemia and tetany
25
Hypothyroidism
- Low T3 and T4
- High TSH
26
Hypothyroidism S/S
- Fatigue, lethargy
- Cold intolerance
- Weight gain
- Thick, brittle fingernails
- Brady
- Hair loss
27
Hypothyroidism Interventions
- Low calorie, high bulk diet
- Levothyroxine
28
Myxedema Coma
Life threatening condition that occurs when hypothyroidism is untreated and poorly managed.
- Resp failure
- Hypotension
- Brady
- Hyponatremia
- Hypoglycemia
- Coma
29
Hepatitis
-Inflammation of liver cells.
30
Cirrhosis
-Permanent scarring of the liver
31
Hepatitis
- Viral is the most common type
- After exposure to virus or toxin the liver becomes enlarged
32
Hep A
- Prevent w vaccination! Best way to prevent Hep A!
- Wash hands
- IGM and IgG
- ALT, AST, ALP, Billirubin all elevated
33
Hep B
- Prevent w vaccination
- No needle sharing, safe sex, not sharing razors, toothbrushes, clean needles for tattoos
- HBsag positive
- ALT, AST, ALP, Billirubin all elevated
34
Hep C
- No vaccine
- Contact w infected blood
- HCV RNA
- ALT, AST, ALP, Billirubin all elevated
35
Expected findings -->
- Fatigue, abdominal pain, fever, vomiting, dark colored urine, jaundice, pruritis
36
Nursing Interventions for Hepatitis
- High carb, high calorie, moderate fat and protein diet
- Avoid alcohol
- Frequent rest periods, avoid exercise
37
Hepatitis Complications
- Chronic Hepatitis
: ongoing inflammation, Hep B/C
- Fulimant Hepatits
: Fatal, no meds, devolep in days
- Cirrhosis
- Liver Failure
- Hepatic encephalopathy
38
Cirrhosis
- Extensive scarring of liver caused by necrotic injury or chronic reaction to inflammation over a prolonged period of time --> replaced w fibrotic tissue which lacks function
39
Postnecrotic
Caused by viral hep, med, toxin
40
Laennec's
Alcohol
41
Billiary
Biliray obstruction
42
Risk factors for Cirrhosis
- Alcohol use disorder
- Chronic viral hep
- Autoimmune hep
- Steatohepatitis ( NASH )
- Damage from meds, toxins
- Severe right sided heart failure
- Billiary cirrhosis
43
S/S Cirrhosis
- Fatigue
- Weight loss, abdominal pain
- Pritus
- Confusion
- GIB: esophageal varices
- Splenomegaly
- Ascites
- Jaundice
- Spider angiomas
- Asterixis
44
Assessment Cirrhosis
Labs
Lab: AST, ALT, ALP, bilirubin elevated, decreased blood protein, decreased albumin, decreased RBC, increased INR, increased ammonia, increase creatine
45
Assessment Cirrhosis
Imaging
- Abdominal ultrasound
- CT
- MRI
46
Assessment Cirrhosis
Diagnostics
- Liver biopsy
- ERCP
47
Cirrhosis Interventions
- Monitor O2 levels, elevate head of the bed 30 degrees with feet elevated
- Decrease itching w cold water and lotion
- Daily weight
- High carb, high protein, moderate fat and low sodium diet
- Monitor ascites
48
Cirrhosis
Responding
- Diuretics ( fluid overload ) beta blockers ( esoph varices ) , lactulose to promote excretion of ammonia through stool
- Paracentesis
- Liver transplant
49
Cirrhosis
Reflecting
- Decrease or no ascites
- Electrolytes WNL
- No hemorrhage
- No alchohol
