MCCN SDAP X - Med-Surg Exam 2 100% Verified
What teaching can we give to the patients? - ANSWER Weigh themselves every morning,
record each daily weight, report if weight increases by 2 lb overnight or 5 lb in one
week. Less than 2g sodium/day. Small, frequent meals to prevent fatigue. Fluid less than
2L/day, count foods that are liquid at room temp, use ice chips vs. water.
Clinical manifestations of Left-sided HF ANSWER Fatigue, activity intolerance, dyspnea,
SOB, cough, orthopnea, cyanosis, crackles, wheezing
Clinical manifestations of Right-sided HF ANSWER Edema, JVD, hepatomegaly,
anorexia and nausea
Risk factors for CAD ANSWER Family/genetic link, age, gender, race, HTN, DM,
metabolic syndrome, obesity, inactivity; women are protected with hormones until after
menopause.
Warning signs of too much activity - ANSWER Pain in chest, down arms, shoulders,
throat or jaw. Irregular HR, extreme fatigue or SOB, blurred vision, sudden weakness in
face, arms or legs, severe leg pain with exercise, lightheadedness, dizziness, confusion,
consistent sore muscles.
Interventions if you find a patient in HF - ANSWER Diuretic, HOB to high fowler's and
lower legs, stop IVF, Administer O2, VS, quick cardiopulmonary assessment, call
physician with labs, CXR, and MAR.
If a client with DVT c/o chest pain - ANSWER Suspect PE! Increase HOB, give O2, VS and
O2SAT, focused assessment, call physician.
Risk factors for DM2 - ANSWER Parent or sibling with DM2, Obesity, sedentary lifestyle,
ethnicity/race, history of GDM or delivery of a baby >9lbs, HTN.
, Absence of insulin - ANSWER Fruity breath, Kussmaul respirations, acidosis,
hyperglycemia (related S/S)
DKA - ANSWER Occurs with DM1, sudden onset, fruity breath
Hyperglycemic-Hyperosmolar State(HHS) - ANSWER Occurs with DM2 has a gradual
onset, give IV insulin, fluids (hot and dry, dehydrated)
Chronic complications of diabetes - ANSWER Vascular disease, retinopathy,
nephropathy, neuropathy
Metabolic syndrome - ANSWER Simultaneous presence of metabolic factors known to
increase risk for developing DM2 and CVD
DM1 - ANSWER Will need insulin replacement forever, cannot take oral anti diabetic
meds (too slow), typically require less insulin, more susceptible to hypoglycemia.
Insulin pump therapy- ANSWER Uses short-acting insulin but releases a small amount
every few minutes and then larger amounts w/ food
DM2- ANSWER Insulin resistance. Fasting glucose >126, OGTT >200 2h after oral
glucose, often associated w/ HTN, hyperlipidemia, and CVD.
Glucocorticoid induced hyperglycemia - ANSWER Corticosteroids may induce diabetes,
especially in those who possess risk factors. This is a prolonged form of stress
hyperglycemia often seen in the hospital setting.
Diabetic foot ulcers - ANSWER Occurs in 15% of all patients with DM, major increase in
amputations and mortality among DM patients.
What teaching can we give to the patients? - ANSWER Weigh themselves every morning,
record each daily weight, report if weight increases by 2 lb overnight or 5 lb in one
week. Less than 2g sodium/day. Small, frequent meals to prevent fatigue. Fluid less than
2L/day, count foods that are liquid at room temp, use ice chips vs. water.
Clinical manifestations of Left-sided HF ANSWER Fatigue, activity intolerance, dyspnea,
SOB, cough, orthopnea, cyanosis, crackles, wheezing
Clinical manifestations of Right-sided HF ANSWER Edema, JVD, hepatomegaly,
anorexia and nausea
Risk factors for CAD ANSWER Family/genetic link, age, gender, race, HTN, DM,
metabolic syndrome, obesity, inactivity; women are protected with hormones until after
menopause.
Warning signs of too much activity - ANSWER Pain in chest, down arms, shoulders,
throat or jaw. Irregular HR, extreme fatigue or SOB, blurred vision, sudden weakness in
face, arms or legs, severe leg pain with exercise, lightheadedness, dizziness, confusion,
consistent sore muscles.
Interventions if you find a patient in HF - ANSWER Diuretic, HOB to high fowler's and
lower legs, stop IVF, Administer O2, VS, quick cardiopulmonary assessment, call
physician with labs, CXR, and MAR.
If a client with DVT c/o chest pain - ANSWER Suspect PE! Increase HOB, give O2, VS and
O2SAT, focused assessment, call physician.
Risk factors for DM2 - ANSWER Parent or sibling with DM2, Obesity, sedentary lifestyle,
ethnicity/race, history of GDM or delivery of a baby >9lbs, HTN.
, Absence of insulin - ANSWER Fruity breath, Kussmaul respirations, acidosis,
hyperglycemia (related S/S)
DKA - ANSWER Occurs with DM1, sudden onset, fruity breath
Hyperglycemic-Hyperosmolar State(HHS) - ANSWER Occurs with DM2 has a gradual
onset, give IV insulin, fluids (hot and dry, dehydrated)
Chronic complications of diabetes - ANSWER Vascular disease, retinopathy,
nephropathy, neuropathy
Metabolic syndrome - ANSWER Simultaneous presence of metabolic factors known to
increase risk for developing DM2 and CVD
DM1 - ANSWER Will need insulin replacement forever, cannot take oral anti diabetic
meds (too slow), typically require less insulin, more susceptible to hypoglycemia.
Insulin pump therapy- ANSWER Uses short-acting insulin but releases a small amount
every few minutes and then larger amounts w/ food
DM2- ANSWER Insulin resistance. Fasting glucose >126, OGTT >200 2h after oral
glucose, often associated w/ HTN, hyperlipidemia, and CVD.
Glucocorticoid induced hyperglycemia - ANSWER Corticosteroids may induce diabetes,
especially in those who possess risk factors. This is a prolonged form of stress
hyperglycemia often seen in the hospital setting.
Diabetic foot ulcers - ANSWER Occurs in 15% of all patients with DM, major increase in
amputations and mortality among DM patients.
