Obesity
True or False:
An underactive thyroid may be related to obesity
True-
Thyroid hormone is responsible for increasing metabolic rate. Deficiency of thyroid hormone leads to weight gain.
What is an esophageal varices?
Varices result from enlarged as well as weakened veins in the esophagus as a result of portal hypertension-
Can be deadly when rupture
Cholelithiasis-what is it?
Gallstones-stomns in the gall bladder
What cells in the Pancreas secrete insulin?
B Cells in the Islets of Langerhans
What is a Hemoglobin A1C lab test?
It is a general estimate of glucose average over the past three months.
What are the effects of steroids on the blood glucose?
It will elevate blood glucose
What can occur if a kidney stone cannot pass through the ureter and becomes stuck?
Hydronephrosis-the fluid collection from intake or IV fluids can cause pressure in the ureter which backs up to the kidney-the pressure can damage the kidney greatly
CLINICAL PEARL: Never push fluids on a renal stone patient or open IV fluids for rapid infusion until the doctor has cleared it is safe
What is the difference between Synthroid and Levothyroxine?
Synthroid is the trade name for this medication used to treat hypothyroidism
Levothryroxine is the generic name
Clinical Pearl-some patients donot respond well to the generic version and will requite the Trade name brand
What is a gastric bypass, also called bariatric surgery?
Altering the stomach by creating a small pouch that connects to the small intestine
Hepatic Encephalopathy is best defined as:
Brain dysfunction as a result of liver disease-due to toxins the liver is not removing. Can lead to motor loss, altered mental status etc. Can be reversible
What is the purpose of the gallbladder?
Storage of bile from the liver
What is adrenal insufficency?
Failure of the adrenal glands to produce cortisol, aldosterone, and androgens.
Also known as Congenital Adrenal Hyperplasia (CAH) as a genetic disorder
How is type II diabetes typically treated?
Oral medications such as Biguanides (metformin, Sulfonylareas (Glipizide), Thiazolidinediones (Rosiglitazone), DPP-4 Inhibotors (Linagliptin), Acarbose, and Repaglinide
Diet
Exercise
What could ridges across the fingernails be indicative of?
Thyroid hormones regulate nail growth-dry brittle nails that break easily are associated with hypothyroidism
Thin brittle nails and separation from the nail bed indicates hyperthyroidism.
Why is a high protein diet an issue for a person with renal impairment?
Diseased or damaged kidneys cannot adequately filter the byproducts of proteins (acids)
If you have a patient that you are caring for post pituitary surgery, why would the nurse be watching for s/s of calcium deficiency?
The parathyroids could have been damaged
They regulate calcium in the body
What is a gastric sleeve surgery?
It is a surgical reduction of the size of the stomach
What causes hepatitis?
Inflammation of the liver-often viral or exposure to a chemical such as alcohol abuse
What is MOST typical pain associated with gallbladder attack? (stones moving)
Pain radiating under right rib cage as well as to shoulder-can mimic MI
What is Cushings Syndrome?
When the body hypersecretes cortisol-Leads to fat accumulation in various areas of the body such as buffalo hump in the neck and other areas fat would not usually store. Thin legs and large belly.
What is ketoacidosis? (DKA)
Body not producing enough insulin-A state of hyperglycemia in which the blood sugar has elevated beyond a measure of 300-and the body is beginning to dehydrate due to fluid loss (urine loss from the body trying to flush out the blood sugar)-the kidneys become stressed and carbolic acid begins to form in the body. Respirations will increase to "blow off" C02 that has also built up in the blood. Urination large amounts.
Can hypothyroidism lead to hair loss?
Yes-hair may become dry, fall out-and become thin
What is tea colored urine indicative of?
Hematuria.
*Remember, however, blood can be present in clear urine-it can be microscopic and will show up in a urine dip
What IV fluids are considered isotonic?
Normal Saline
D5W
Lactated Ringers
What are two nursing diagnoses related to gastric bypass surgery?
Alteration in Nutrition
Risk for Dehydration
(Many others)
What are standard immunizations against hepatitis?
Hepatitis A and B Vaccines
There is no C vaccine
Where are the Islets of Langerhans located?
Pancreas
What hormones does the pituitary produce?
Growth Hormone (growth of tissues, bones, muscles)
Thyroid stimulating hormone (to stimulate Thyroxine)
Follicle Stimulating Hormone (Ovaries and testes)
Prolactin (Breast Milk production)
Lutenizing Hormone (ovaries and testes)
ACTH (tells adrenal glands to produce cortisol and other steroid hormones)
Why is skin healing impaired in the diabetic patient?
Weakened immune response
Reduced circulation
Possible nerve damage
Reduced Collagen production
What type of burn is a sunburn with regards to first, second, or third degree?
First degree
What does the abbreviation CKD mean?
Chronic Kidney Disease
You are the nurse caring for a patient who has not voided and is reporting severe bladder pain and bladder distention. You obtain an order for a foley catheter and within minutes already have 800 cc of urine draining with more left in the bladder. Why do some providers instruct you to clamp the catheter, then reopen intermittently?
The answer is NOT because the blood pressure could drop. MYTH!
The fluid is in a sterile resvoir and not in the circulating blood.
ANSWER: The bladder is a muscular organ-too rapid of a reduction in size can lead to spasm as well as loss of elasticity.
Non-surgical Interventions for Obesity?
1) Prescriptions/meds (GLP-1)
2) Dietary Modifications and Exercise
3) Psychotherapy and Coaching
Is Hepatitis C curable?
Yes-in many cases with the proper treatment. Older cases already treated with earlier meds may not be.
Can a person live without a gallbladder?
Yes-surgical removal is called Cholecystectomy
What is Graves disease?
hyperthyroidism
Characterized by a bulge in one or both eyes as well as weight loss, rapid pulse, irregular heartbeat.
May be treated with surgically or chemically reducing the thyroid function.
What is renal calculi?
Kidney stone.
Caused by either uric acid or calcium oxylate
What is a primary goal when treating a burn wound?
Prevent infection
Symptoms of a renal stone include?
Flank pain
Hematuria
Fever
What type of urinary catheter may be used for male that has a swollen prostate?
Coude
Pronouned KU-day
Causes of Obesity: Name 2
1) Genetics
2) Sedentary Lifestyle
3) Cultural Influence
4) Hypothyroidism
What are certain restrictions for patients with liver disease?
Limit or no acetaminophen (tylenol)
No alcohol
Avoid high amounts animal protein
The symptoms are normally not even noticed until advanced cancer is present. Typically with treatment, life span is a year or less after discovery.
Very difficult cancer to treat.
What is the function of the parathyroid glands?
To regulate calcium in the blood by secreting calcitonin. It causes bones to release calcium. A deficiency in calcitonin may result in pathological fractures and other weaknesses in bones as well as calcium deficiency in the blood.
Why would a patient be given Sodium Bicarb if they are DKA (Diabetic Ketoacidosis)?
Sodium Bicarb will help to correct the state of acidosis
Remmeber-Normal acid base is 7.35-7.45
PH below 7.35 is acidosis
Above 7.45 is alkalosis
Which is more dangerous as a source of infection? A non-poisonous spider bite or a mild dog bite?
The spider bite-any fanged creature injects whatever organisms are on the skin (such as MRSA) directly into the tissue.
Although not good, dog bites have more of a tearing action than injecting action
What is the most common organism that leads to UTI in females?
E Coli
*If sexually active and having recurrent infections-could be an anatomical issue , sexual practice, or hygiene of patient or partner!
What is the best definition of an endocrine gland?
A gland that secretes a hormone directly into the bloodstraem