Hondros College – NUR 212 – Exam 3 Study
Guide with Correct Answers
Health risk associated with obesity -
✔️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 -
✔️Restricting dietary intake so that it is below energy requirements- includes all food groups
Criteria guidelines for bariatric surgery -
✔️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 -
✔️Leak at site of anastomosis, anemia, calcium deficiency, dumping syndrome, irreversible
Dumping syndrome -
✔️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 -
✔️tachycardia, fever, tachypnea, chest and abdominal pain
Post operative care for bariatric surgery -
✔️assess for cardiopulmonary complications, thrombus formation, anastomosis leaks and
electrolyte imbalances, maintain the head of the 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 definiton -
,✔️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 -
✔️Insulin resistance related to excess visceral fat
Criteria for metabolic syndrome -
✔️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 -
✔️Impaired fasting blood glucose, HTN, abnormal cholesterol levels and obesity
counterregulatory hormones- increase blood glucose levels -
✔️glucagon, epinephrine, GH, cortisol
C peptide in serum and urine -
✔️useful clinical indicator of pancreatic b cell function and insulin levels
Signs and symptoms of type 1 diabetes -
✔️polyuria, polydipsia, polyphagia, weight loss may occur, weakness and fatigue
signs and symptoms of type 2 diabetes -
✔️poor wound healing, recurrent infections, dry skin, 3 Ps, drowsiness, hunger
Diagnosis of diabetes -
✔️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) -
✔️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 -
✔️less than 7.0
Fructosamine -
✔️Is another way to assess glucose levels,, reflects glycemia in the previous 1 to 3 weeks
Islet cell antoantibody -
✔️testing is primarily done to help distinguish between autoimmune type 1 diabetes and diabetes
from other causes
Rapid acting insulin (lispro, aspart) -
✔️Onset 10-30 min
Peak- 30 min- 3hr
Duration- 3 - 5 hour
Short acting (regular Humulin R, Novolin R) -
✔️Onset 30min- 1hr
Peak- 2-5hr
Duration- 5-8hr
ONLY INSULIN THAT CAN BE GIVEN IV!!
Intermediate acting insulin (NPH) -
✔️Onset- 1.5-4hr
Peak- 4-12hr
Duration- 12- 18hr
Gently agitate before administering
Guide with Correct Answers
Health risk associated with obesity -
✔️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 -
✔️Restricting dietary intake so that it is below energy requirements- includes all food groups
Criteria guidelines for bariatric surgery -
✔️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 -
✔️Leak at site of anastomosis, anemia, calcium deficiency, dumping syndrome, irreversible
Dumping syndrome -
✔️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 -
✔️tachycardia, fever, tachypnea, chest and abdominal pain
Post operative care for bariatric surgery -
✔️assess for cardiopulmonary complications, thrombus formation, anastomosis leaks and
electrolyte imbalances, maintain the head of the 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 definiton -
,✔️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 -
✔️Insulin resistance related to excess visceral fat
Criteria for metabolic syndrome -
✔️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 -
✔️Impaired fasting blood glucose, HTN, abnormal cholesterol levels and obesity
counterregulatory hormones- increase blood glucose levels -
✔️glucagon, epinephrine, GH, cortisol
C peptide in serum and urine -
✔️useful clinical indicator of pancreatic b cell function and insulin levels
Signs and symptoms of type 1 diabetes -
✔️polyuria, polydipsia, polyphagia, weight loss may occur, weakness and fatigue
signs and symptoms of type 2 diabetes -
✔️poor wound healing, recurrent infections, dry skin, 3 Ps, drowsiness, hunger
Diagnosis of diabetes -
✔️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) -
✔️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 -
✔️less than 7.0
Fructosamine -
✔️Is another way to assess glucose levels,, reflects glycemia in the previous 1 to 3 weeks
Islet cell antoantibody -
✔️testing is primarily done to help distinguish between autoimmune type 1 diabetes and diabetes
from other causes
Rapid acting insulin (lispro, aspart) -
✔️Onset 10-30 min
Peak- 30 min- 3hr
Duration- 3 - 5 hour
Short acting (regular Humulin R, Novolin R) -
✔️Onset 30min- 1hr
Peak- 2-5hr
Duration- 5-8hr
ONLY INSULIN THAT CAN BE GIVEN IV!!
Intermediate acting insulin (NPH) -
✔️Onset- 1.5-4hr
Peak- 4-12hr
Duration- 12- 18hr
Gently agitate before administering
