NUR 212 Exam 3: Questions & Answers
Health risk associated with obesity (Ans- Depression, T2DM, metabolic syndrome, polycystic ovary disease, sleep apnea, asthma, pulmonary HTN, menstrual irregularities, infertility, gestational diabetes, huperlipidemia, sudden cardiac death, a fib, HTN, CAD, DVT, right sided HF, NASH, gallstones, GERD, kidney cancer, CKD, esophagus, pancreas, thyroid, colorectal and gallbladder cancer, breast and ovarian cancer
Nutritional therapy for obesity (Ans- Restricting dietary intake so that it is below energy requirements- includes all food groups
Criteria guidelines for bariatric surgery (Ans- BMI of 40 or more or a BMI of 35 or more with other significant co- morbidities (HTN, T2DM, HF, sleep apnea)
Disadvantages of Roux-en-Y gastric bypass (Ans- Leak at site of anastomosis, anemia, calcium deficiency, dumping syndrome, irreversible
Dumping syndrome (Ans- Gastric contents empty too rabidly into the small intestine, overwhelming its ability to digest nutrients. Symptoms include n/v, weakness, sweating, faintness and sometimes diarrhea. Pt is instructed to avoid sugary foods after surgery
Anastomosis leak (Ans- tachycardia, fever, tachypnea, chest and abdominal pain
Post operative care for bariatric surgery (Ans- assess for cardiopulmonary complications, thrombus formation, anastomosis leaks and electrolyte imbalances, maintain the head of the 1 / 3
bed at a minimum of a 45 degree angle to reduce abdominal pressure and increase lung expansion, pts should not consume fluids with meals
Metabolic syndrome definition (Ans- is a group of metabolic risk factors that increase a person's change of developing CVD, stroke, diabetes. It is a cluster of heath problems, including obesity, HTN, abnormal lipid levels, and high blood glucose
The main underlying risk factor for metabolic syndrome (Ans- Insulin resistance related to excess visceral fat
Criteria for metabolic syndrome (Ans- Need any 3 of the 5- waist circumference- >40in in men and >35 in women, Triglycerides- >150 or on drug treatment for high triglycerides, HDL cholesterol- <40 in men <50 in women or drug treatment for high cholesterol, BP- >130 sys >85 diastolic or on drug treatment for HTN, fasting blood glucose >100 or on drug treatment for elevated blood glucose
Signs and symptoms of metabolic syndrome (Ans- Impaired fasting blood glucose, HTN, abnormal cholesterol levels and obesity
counterregulatory hormones- increase blood glucose levels (Ans- glucagon, epinephrine, GH, cortisol
C peptide in serum and urine (Ans- useful clinical indicator of pancreatic b cell function and insulin levels
Signs and symptoms of type 1 diabetes (Ans- polyuria, polydipsia, polyphagia, weight loss may occur, weakness and fatigue
signs and symptoms of type 2 diabetes (Ans- poor wound healing, recurrent infections, dry skin, 3 Ps, drowsiness, hunger 2 / 3
Diagnosis of diabetes (Ans- A1C of 6.5 or higher, fasting plasma glucose level of 126 or greater, a 2 hour plasma glucose level of 200 or greater during an OGTT using a glucose load of 75g, in a pt with classic symptoms of hyperglycemia (polyuria, polydipsia, unexplained weight loss) or hyperglycemic crisis, a random blood glucose level of 200 or more
A1C (glycosylated hemoglobin) (Ans- provides a measurement of blood glucose levels over the previous 2 to 3 months Diseases affecting RBCs (anemia) can influence the AIC
Goal A1C for pts with diabetes (Ans- less than 7.0
Fructosamine (Ans- Is another way to assess glucose levels,, reflects glycemia in the previous 1 to 3 weeks
Islet cell antoantibody (Ans- testing is primarily done to help distinguish between autoimmune type 1 diabetes and diabetes from other causes
Rapid acting insulin (lispro, aspart) (Ans- Onset 10-30 min Peak- 30 min- 3hr Duration- 3 - 5 hour
Short acting (regular Humulin R, Novolin R) (Ans- Onset 30min- 1hr Peak- 2-5hr Duration- 5-8hr
- / 3