NP235 Exam 2 Review
What is Adrenal Crisis? - Answer Physical stress from the flu or other infection, or from
surgery, can send a patient with Addison disease into Addisonian crisis. Another
situation that can cause symptoms of acute lack of cortisol results from prescribed
treatment.
What are s/s of adrenal crisis? - Answer The patient experiences generalized malaise
and muscle weakness, muscle pain, orthostatic hypotension, and vulnerability to cardiac
dysrhythmias. Insufficiency of the glucocorticoids affects blood glucose levels and
causes symptoms of hypoglycemia. There is also decreased secretion of
gastrointestinal enzymes, which results in anorexia, nausea and vomiting, flatulence,
and diarrhea. These symptoms, as well as anxiety, depression, and loss of mental
acuity, have been correlated with the absence of the peaks of cortisol output that
normally occur every 24 hours.
What is DIC? - Answer Damaged tissue liberates tissue thromboplastin, creating a state
of excessive clotting in the microcirculation throughout the body. When excessive
clotting depletes the body's clotting factors, hemorrhage follows, leading to hypotension
or shock.
What are s/s of DIC - Answer Continued bleeding from an injection or IV site, extensive
bruising in areas of injury, ecchymoses where there has been no trauma, and
petechiae.
There may be oral, vaginal, or rectal bleeding. Laboratory studies will reveal a
decreased hemoglobin and low platelet count.
The prothrombin and activated partial thromboplastin times will be increased.
The fibrinogen level is reduced, and the fibrin degradation products level is increased.
The D-dimer result is elevated.
What are s/s of hypoglycemia? - Answer Increase pulse, confusion, HA, Nervous,
Nausea, Cool and clammy skin, shaking
where is insulin manufactured in the body - Answer The pancreas is both an endocrine
(secretes into the bloodstream) and exocrine (secretes through a duct to the target
tissues) gland. Its endocrine function is to produce the hormones insulin and glucagon.
What is diabetes mellitus type 2 - Answer formerly called non-insulin-dependent
diabetes mellitus (NIDDM)—makes up 90% to 95% of all known cases of diabetes.
Type 2 diabetes is believed to begin with insulin resistance, in which insulin interaction
with glucose becomes less efficient, and therefore glucose metabolism is abnormal.
More insulin is produced by the pancreas to maintain cellular metabolism. Type 2
diabetes has a tendency to develop later in life than does type 1, and patients with type
2 rarely develop diabetic ketoacidosis.
, What are some risk factors for DM type 2? - Answer obesity
asian, hispanic, african american, American Indian
In type 2 diabetes there also seems to be a relationship to aging and a reduction in the
function of the pancreatic beta cells and how they synthesize insulin.
Raynaud's disease - Answer characterized by spasm of the arteries of the upper and
lower extremities with an exaggerated response to cold and stress, resulting in bilateral
vasospasm.
what education would you provide to your patient to prevent complications of Raynauds
disease - Answer protect the extremities from cold, stress, vasoconstriction!
The patient should be taught to:
Dress warmly when in cold environments.
Clothing should be layered and nonrestrictive. Hat, gloves, and warm socks should be
worn.
Wear protective gloves when reaching into ovens and when handling extremely cold
items.
Avoid cold temperatures when possible, to manage stress, and to stop tobacco use.
Caffeine intake should be limited.
If appropriate, the patient should be referred to a smoking cessation program.
What does a patient take thrombolytics for - Answer give to stroke pts.
they disolve clots.
at risk for hemorrage.
Anticoagulants work by preventing blood clots from forming. Some do this by preventing
the body from making clotting factors. Others keep the clotting factors from working or
prevent other chemicals from forming so that clots can't develop
What is the priority in treating sickle cell patients - Answer administration of oxygen,
pain-relieving drugs, and oral and intravenous fluids to reduce pain and prevent
complications. Doctors also may recommend blood transfusions, folic acid supplements,
and antibiotics.
A bone marrow transplant may be an effective treatment in some circumstances
What would be the plan of care for a patient with Peripheral Vascular Disease? -
Answer Reduction of high blood pressure(2)
Long-term control to decrease the risk of stroke, heart attack, loss of vision, and kidney
disease. The target is to control blood pressure at or below 120/80 mm Hg.
What is Adrenal Crisis? - Answer Physical stress from the flu or other infection, or from
surgery, can send a patient with Addison disease into Addisonian crisis. Another
situation that can cause symptoms of acute lack of cortisol results from prescribed
treatment.
What are s/s of adrenal crisis? - Answer The patient experiences generalized malaise
and muscle weakness, muscle pain, orthostatic hypotension, and vulnerability to cardiac
dysrhythmias. Insufficiency of the glucocorticoids affects blood glucose levels and
causes symptoms of hypoglycemia. There is also decreased secretion of
gastrointestinal enzymes, which results in anorexia, nausea and vomiting, flatulence,
and diarrhea. These symptoms, as well as anxiety, depression, and loss of mental
acuity, have been correlated with the absence of the peaks of cortisol output that
normally occur every 24 hours.
What is DIC? - Answer Damaged tissue liberates tissue thromboplastin, creating a state
of excessive clotting in the microcirculation throughout the body. When excessive
clotting depletes the body's clotting factors, hemorrhage follows, leading to hypotension
or shock.
What are s/s of DIC - Answer Continued bleeding from an injection or IV site, extensive
bruising in areas of injury, ecchymoses where there has been no trauma, and
petechiae.
There may be oral, vaginal, or rectal bleeding. Laboratory studies will reveal a
decreased hemoglobin and low platelet count.
The prothrombin and activated partial thromboplastin times will be increased.
The fibrinogen level is reduced, and the fibrin degradation products level is increased.
The D-dimer result is elevated.
What are s/s of hypoglycemia? - Answer Increase pulse, confusion, HA, Nervous,
Nausea, Cool and clammy skin, shaking
where is insulin manufactured in the body - Answer The pancreas is both an endocrine
(secretes into the bloodstream) and exocrine (secretes through a duct to the target
tissues) gland. Its endocrine function is to produce the hormones insulin and glucagon.
What is diabetes mellitus type 2 - Answer formerly called non-insulin-dependent
diabetes mellitus (NIDDM)—makes up 90% to 95% of all known cases of diabetes.
Type 2 diabetes is believed to begin with insulin resistance, in which insulin interaction
with glucose becomes less efficient, and therefore glucose metabolism is abnormal.
More insulin is produced by the pancreas to maintain cellular metabolism. Type 2
diabetes has a tendency to develop later in life than does type 1, and patients with type
2 rarely develop diabetic ketoacidosis.
, What are some risk factors for DM type 2? - Answer obesity
asian, hispanic, african american, American Indian
In type 2 diabetes there also seems to be a relationship to aging and a reduction in the
function of the pancreatic beta cells and how they synthesize insulin.
Raynaud's disease - Answer characterized by spasm of the arteries of the upper and
lower extremities with an exaggerated response to cold and stress, resulting in bilateral
vasospasm.
what education would you provide to your patient to prevent complications of Raynauds
disease - Answer protect the extremities from cold, stress, vasoconstriction!
The patient should be taught to:
Dress warmly when in cold environments.
Clothing should be layered and nonrestrictive. Hat, gloves, and warm socks should be
worn.
Wear protective gloves when reaching into ovens and when handling extremely cold
items.
Avoid cold temperatures when possible, to manage stress, and to stop tobacco use.
Caffeine intake should be limited.
If appropriate, the patient should be referred to a smoking cessation program.
What does a patient take thrombolytics for - Answer give to stroke pts.
they disolve clots.
at risk for hemorrage.
Anticoagulants work by preventing blood clots from forming. Some do this by preventing
the body from making clotting factors. Others keep the clotting factors from working or
prevent other chemicals from forming so that clots can't develop
What is the priority in treating sickle cell patients - Answer administration of oxygen,
pain-relieving drugs, and oral and intravenous fluids to reduce pain and prevent
complications. Doctors also may recommend blood transfusions, folic acid supplements,
and antibiotics.
A bone marrow transplant may be an effective treatment in some circumstances
What would be the plan of care for a patient with Peripheral Vascular Disease? -
Answer Reduction of high blood pressure(2)
Long-term control to decrease the risk of stroke, heart attack, loss of vision, and kidney
disease. The target is to control blood pressure at or below 120/80 mm Hg.
