Study Guide for Exam 3: Geriatrics
Unit 6: Metabolic Disorders – Diabetes Mellitus
Type 1 Diabetes:
• Autoimmune destruction of pancreatic beta cells leads to absolute insulin
deficiency.
• Typically manifests before age 30 with abrupt onset.
• Classic symptoms: polydipsia (increased thirst), polyuria (frequent urination),
polyphagia (increased hunger).
Type 1 Diabetes Mellitus:
• Polyuria: Excessive urination due to osmotic diuresis from hyperglycemia.
• Polydipsia: Increased thirst resulting from dehydration.
• Polyphagia: Increased hunger due to cellular glucose deprivation.
• Weight Loss: Despite increased appetite, weight loss occurs from fat and muscle
breakdown.
• Fatigue: Lack of glucose in cells leads to decreased energy.
• Blurred Vision: High blood glucose levels can cause lens swelling
•
Type 2 Diabetes:
• Characterized by insulin resistance and relative insulin deficiency.
• Accounts for 90–95% of diabetes cases, often with gradual onset in older adults.
• Risk factors include obesity, sedentary lifestyle, and family history.
Type 2 Diabetes Mellitus:
• Often Asymptomatic: May be diagnosed during routine screenings.
• Fatigue: Due to insulin resistance and impaired glucose utilization.
• Recurrent Infections: High glucose levels promote bacterial growth.
• Delayed Wound Healing: Impaired circulation and immune response.
• Visual Disturbances: Due to diabetic retinopathy.
• Neuropathy: Tingling or numbness, especially in extremities.
, Nursing Considerations:
• Monitor blood glucose levels and educate patients on self-management.
• Promote lifestyle modifications: balanced diet, regular exercise, weight
management.
• Assess for complications: neuropathy, retinopathy, nephropathy, cardiovascular
disease.
Important Considerations:
• Foot Care: Daily inspection using a mirror; seek assistance if needed.
• Blood Glucose Monitoring: Maintain levels to prevent hypoglycemia (<60 mg/dL)
and hyperglycemia.
• A1C Levels: Aim for levels below 7%; higher levels indicate poor control.
• Illness Management: Continue monitoring glucose; consult healthcare provider if
unable to eat or if vomiting occurs
Unit 7: Neurological Disorders – Parkinson’s Disease
Key Features:
1. Resting Tremor:
a. Often the initial symptoms; typically, asymmetrical.
b. Diminishes with voluntary movement and absence during sleep.
2. Muscle Rigidity:
a. "Cogwheel" rigidity: a ratchety resistance to passive movement.
3. Bradykinesia:
a. Slowness of movement, affecting daily activities.
4. Postural Instability:
a. Impaired balance and coordination, increasing fall risk.
Nursing Considerations:
• Assist with mobility and implement fall prevention strategies.
• Monitor for medication side effects, especially from dopaminergic therapies.
Unit 6: Metabolic Disorders – Diabetes Mellitus
Type 1 Diabetes:
• Autoimmune destruction of pancreatic beta cells leads to absolute insulin
deficiency.
• Typically manifests before age 30 with abrupt onset.
• Classic symptoms: polydipsia (increased thirst), polyuria (frequent urination),
polyphagia (increased hunger).
Type 1 Diabetes Mellitus:
• Polyuria: Excessive urination due to osmotic diuresis from hyperglycemia.
• Polydipsia: Increased thirst resulting from dehydration.
• Polyphagia: Increased hunger due to cellular glucose deprivation.
• Weight Loss: Despite increased appetite, weight loss occurs from fat and muscle
breakdown.
• Fatigue: Lack of glucose in cells leads to decreased energy.
• Blurred Vision: High blood glucose levels can cause lens swelling
•
Type 2 Diabetes:
• Characterized by insulin resistance and relative insulin deficiency.
• Accounts for 90–95% of diabetes cases, often with gradual onset in older adults.
• Risk factors include obesity, sedentary lifestyle, and family history.
Type 2 Diabetes Mellitus:
• Often Asymptomatic: May be diagnosed during routine screenings.
• Fatigue: Due to insulin resistance and impaired glucose utilization.
• Recurrent Infections: High glucose levels promote bacterial growth.
• Delayed Wound Healing: Impaired circulation and immune response.
• Visual Disturbances: Due to diabetic retinopathy.
• Neuropathy: Tingling or numbness, especially in extremities.
, Nursing Considerations:
• Monitor blood glucose levels and educate patients on self-management.
• Promote lifestyle modifications: balanced diet, regular exercise, weight
management.
• Assess for complications: neuropathy, retinopathy, nephropathy, cardiovascular
disease.
Important Considerations:
• Foot Care: Daily inspection using a mirror; seek assistance if needed.
• Blood Glucose Monitoring: Maintain levels to prevent hypoglycemia (<60 mg/dL)
and hyperglycemia.
• A1C Levels: Aim for levels below 7%; higher levels indicate poor control.
• Illness Management: Continue monitoring glucose; consult healthcare provider if
unable to eat or if vomiting occurs
Unit 7: Neurological Disorders – Parkinson’s Disease
Key Features:
1. Resting Tremor:
a. Often the initial symptoms; typically, asymmetrical.
b. Diminishes with voluntary movement and absence during sleep.
2. Muscle Rigidity:
a. "Cogwheel" rigidity: a ratchety resistance to passive movement.
3. Bradykinesia:
a. Slowness of movement, affecting daily activities.
4. Postural Instability:
a. Impaired balance and coordination, increasing fall risk.
Nursing Considerations:
• Assist with mobility and implement fall prevention strategies.
• Monitor for medication side effects, especially from dopaminergic therapies.
