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lifespan final > Metabolism > Flashcards

Metabolism Flashcards

1
Q

Hormones that increase blood glucose levels

A

Epinephrine, norepinephrine, growth hormone, and cortisol.

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2
Q

Hemoglobin A1C

A

Normal range: 4-6%, DM diagnosed if greater than 6.5%.

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3
Q

Fasting blood glucose

A

Normal range 70-100, DM if equal to or greater than 126 on two separate occasions

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4
Q

Oral glucose tolerance test

A

Normal range <140, two-hour blood glucose equal to or greater than 200 during oral testing

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5
Q

Pediatric 8-hour fasting

A

blood glucose of 126 or more

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6
Q

Pediatric random

A

200 or more accompanied by classic sign of diabetes

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7
Q

Pediatric oral glucose tolerance test

A

200 or more in 2-hour sample

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8
Q

Pediatric A1C

A

6.5% or more

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9
Q

Hyperglycemia

A

fasting blood glucose >130 or >180 1-2 hours after eating

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10
Q

Hyperglycemia early symptoms

A

sweating, irritability, tremors, anxiety, tachycardia, hunger

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11
Q

Hyperglycemia late symptoms

A

confusion, paralysis seizure, coma

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12
Q

Hypoglycemia

A

> 70

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13
Q

Hypoglycemia early symptoms

A

sweating, irritability, tremors, anxiety, tachycardia, hunger

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14
Q

Hypoglycemia late symptoms

A

confusion, paralysis seizures, coma

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15
Q
A
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16
Q

DM pre-op care

A

sulfonylureas D/C’d one day before surgery, metformin stopped at least 24 hrs. before surgery and only restarted after kidney function is documented as normal, all other oral drugs stopped day of procedure, if taking long-acting insulins may need to be switched to immediate-acting. Pre-op BG should be <200.

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17
Q

DM intraoperative care

A

BG between 140-180 during surgery.

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18
Q

DM post-op assessment

A

frequent vital signs, balancing hormones often activated and cause hyperglycemia before fever, ECG monitoring / fluid and electrolyte assessment: hyperkalemia common in patients w/ mild to moderate kidney failure and can lead to cardiac dysrhythmias. In others hypokalemia may occur and made worse by insulin/glucose given during surgery.

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19
Q
A
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20
Q
A
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21
Q

DM management

A

Keep A1C at <7%, premeal BG 70-130, peak after meal <180, maintain appropriate weight, vison tests annually, keep appointments w/provider.

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22
Q

DM nutrition

A

Carb counting, at least 25g of fiber/day, focus is on quality of fat rather than quantity.

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23
Q

DM exercise

A

150 min/week do not exercise if ketones present, if type 1 perform vigorous exercise only when BG is 100-250 and ketones not in urine.

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24
Q

Hepatitis testing

A

acute elevations in liver enzymes, hepatitis antibodies, ultrasound, liver biopsy

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25
Q

Hepatitis A

A

Caused by Hep A virus, flu-like symptoms, fecal-oral route.

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26
Q

Hep B

A

Often asymptomatic, unprotected sex, sharing needles, blood transfusions before 1992, hemodialysis, direct contact, birth.

27
Q

Hep B diagnostics

A

blood test confirms, most recover and clear virus, carriers can infect others even if not sick, chronic carriers at high risk for cirrhosis and liver cancer.

28
Q

Hep C

A

Leading cause of end-stage liver disease, asymptomatic until liver problems occur or detected by lab, contracted through blood.

29
Q

Hep C mode of transmission

A

Incubation period 2 weeks-6 months, acute infection and illness not common, can be diagnosed months or years later, causes chronic inflammation in liver which leads to cirrhosis.

30
Q

Hep C management

A

Diet high in carbs and calories w/moderate fat intake, protein added after nausea/anorexia subside, allow liver rest.

31
Q

Hypothyroidism causes

A

Hashimoto’s thyroiditis, over-response to hyperthyroidism treatment, thyroid surgery, radiation therapy, medications such as lithium, congenital disease, pituitary disorder, pregnancy, Iodine deficiency.

32
Q

Hypothyroidism risk factors

A

females 30-60yr, family hx, autoimmune disease, radioactive iodine or anti-thyroid medications, radiation to neck or upper chest, thyroid surgery, pregnant or given birth w/in last 6 months

33
Q

Hypothyroidism diagnostic testing

A

Reduced TH/T3/ T4, elevated TSH in primary decreased in secondary or tertiary

34
Q

Serum T3

A

70-205

35
Q

Serum T4 (total)

A

4-12

36
Q

Free T4 index

A

0.8-2.8

37
Q

TSH

A

0.3-5

38
Q

Hypothyroidism cues

A

Enlarged thyroid gland, fatigue, increased sensitivity to cold, constipation, dry skin, weight gain, puffy face, hoarseness, muscle weakness, elevated cholesterol level, muscle aches, tenderness, stiffness, pain/stiffness/swelling in joints, heavier or irregular menstrual period, thinning hair, slowed heart rate, depression, impaired memory.

39
Q

Hypothyroidism in newborns

A

Large protruding tongue, difficulty breathing, hoarse crying, umbilical hernia, jaundice.

40
Q

Hypothyroidism infants

A

Trouble feeding and growing, constipation, poor muscle tone, excessive sleepiness.

41
Q

Hypothyroidism in children and teens

A

Poor growth, delayed development of permanent teeth, delayed puberty, poor mental development.

42
Q

Hypothyroidism complications

A

Goiter, increased risk of heart disease/failure due to high LDL, depression or slowed mental functioning, peripheral neuropathy.

43
Q

Myxedema in hypothyroidism

A

Rare life-threatening condition due to long-term undiagnosed hypothyroidism, intense cold intolerance, drowsiness followed by profound lethargy and unconsciousness, may be triggered by sedatives/infection/or stress, dangerously reduced cardiopulmonary and neurologic functioning.

44
Q

Hypothyroidism Pulmonary

A

Hypoventilation, pleural effusion, dyspnea

45
Q

Hypothyroidism cardiovascular

A

Bradycardia, dysrhythmias, enlarged heart, decreased activity intolerance, hypotension.

46
Q

Hypothyroidism metabolic

A

decreased basal metabolic rate, decreased body temp, cold intolerance

47
Q

Hypothyroidism integumentary

A

Cool/pale/yellowish/dry/coarse/scaly skin, thick brittle nails, dry/coarse/brittle hair, decreased hair growth and loss of eyebrow hair, poor wound healing.

48
Q

Hypothyroidism other symptoms

A

Periorbital edema, facial puffiness, non-pitting edema of hands and feet, hoarseness, increased sensitivity to opioids and tranquilizers, decreased urine output, iron deficiency anemia.

49
Q

Emergency care myxedema coma

A

maintain patent airway, replace fluids w/ IV normal or hypertonic saline as prescribed, give levothyroxine sodium IV as prescribed, give glucose IV as prescribed, give corticosteroids as prescribed, check temp and BP hourly, cover w/ warm blankets, monitor LOC every 8 hrs., turn every 2hrs, aspiration precautions.

50
Q

Hyperthyroidism causes

A

Graves disease, thyroid nodules, thyroiditis, too much iodine,

51
Q

Hyperthyroidism risk factors

A

Female, over 60, pregnant or gave birth w/in last 6 months, thyroid surgery or problem, family hx, anemia, type 1 DM, primary adrenal insufficiency.

52
Q

Hyperthyroidism diagnostic

A

Low TSH, elevated T3/T4, thyroid scan, ultrasonography, ECG.

53
Q

Hyperthyroidism cues

A

nervousness or irritability, fatigue, muscle weakness, trouble tolerating heat, insomnia, tremors, rapid and irregular heartbeat, frequent bowel movements or diarrhea, weight loss, mood swings, goiter, over 60yr may lose appetite, withdrawn.

54
Q

Thyroid storm

A

Life-threatening in uncontrolled hyperthyroidism usually w/graves, can be triggered by stress/trauma/infection/DKA/ pregnancy, high fever/severe hypertension/tachycardia immediately report temp of 1 degree, reduce stimulation, promote comfort.

55
Q

Hyperthyroidism Cardiopulmonary

A

Palpitations, chest pain, increased systolic BP, tachycardia, dysrhythmias, rapid shallow respirations

56
Q

Hyperthyroidism metabolic

A

increased basal metabolic rate, heat intolerance, low-grade fever, fatigue

57
Q

Hyperthyroidism neurologic

A

blurred or double vision, eye fatigue, increased tears, injected red conjunctiva, photophobia, eyelid retraction or lag, globe lag, hyperactive deep tendon reflexes, tremors, insomnia

58
Q

Hyperthyroidism integumentary

A

diaphoresis, fine/soft/silky body hair, smooth/warm/moist skin, thinning of scalp hair

59
Q

Hyperthyroidism Psychosocial

A

Decreased attention span, restlessness and irritability, emotional instability, manic behavior

60
Q

Hyperthyroidism surgical intervention and preoperative care

A

Thyroidectomy, thionamides, iodine preparations, hypertension, dysrhythmias, and tachycardia must be controlled

61
Q

Thyroidectomy post-op care

A

monitor for complications, hemorrhage (most likely first 24hrs), respiratory distress, assess voice every 2hrs and document changes

62
Q

Thyroiditis

A

Acute inflammation of thyroid gland, acute thyroiditis is caused by bacterial invasion of thyroid gland, subacute (granulomatous) from viral infection following upper respiratory infection, Hashimoto’s is most common type

63
Q

Thyroid cancer

A

Papillary/follicular/medullary/anaplastic, starts as single painless pump or nodule, elevated serum tg level

lifespan final (12 decks)

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