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NURS 623 Exam2_CaryReview+Questions.

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NURS 623 Exam2_CaryReview+Questions.

 Know what effects exercise and diet have on the body, on blood glucose, blood
pressure, cholesterol

A patient with type 2 diabetes asks the clinician why she needs to
exercise. In order to answer her, the clinician must understand that
exercise has what effect on the patient with type 2 diabetes?
a. Reduces postprandial blood
glucose
b. Reduces triglycerides and
increases high-density lipoprotein
(HDL)
c. Reduces total cholesterol
d. All of the above



 Know the frequency in which you would perform a foot exam on a DM patient

How often should the clinician examine the feet of a person with
diabetes?
a. Once a year
b. Every 6 months
c. Every 3 months
d. Every visit

 Know the diferenece in addsions, cushings and graves disease and s/s pts will exhibit,
and Understand the patho related to the disease process

Addisons:

-Need to ADD cortisol
o Inadequate amount of hormones produced by the adrenal glands
o Cortisol and sometimes aldosterone for this disease
o GI
 Diarrhea, nausea, vomiting, weight loss d/t loss of appetite
o Derm
 Paleness or darkening of skin in places that causes the skin to have a patchy
appearance
o Other
 Muscle weakness, fatigue, slow or sluggish movement, hypoglycemia, low blood
pressure, fainting, and salt craving
Cushings:

-Have a CUSHION of cortisol

, NURS 623 Exam2_CaryReview+Questions.
 Cushing’s Disease
o ACTH-Dependent:
o Related to excess ACTH caused by pituitary adenoma causes adrenal cortex to over
secrete cortisol
 Cushing’s Syndrome
o ACTH-Independent
o Prolonged use of exogenous glucocorticoid hormones
 Most common cause: HD steroid > 2 weeks
o Tumors/dysplagia of the adrenal cortex
 S/S:
o Progressive weight gain and fatty tissue deposit
 Midsection/Upper back
 Face (moon face)
 Between shoulders (buffalo hump)
o Pink or purple stretch marks (Striae)
 Abdomen
 Thighs
 Breasts
 Arms
o Thinning, fragile skin that bruises easily
o Slow healing of cuts, Insect bites, acne, and infections
o Fatigue, muscle weakness or myopathy
o Depression/anxiety and irritability
o HTN
o Glucose intolerance that can lead to DM, HA, and bone loss
o Women reports more thick and visible facial hair (hirsutism) and period issues

Graves:

 Excess secretion and synthesis of one or both:
o Thyroxine (T4)
o Triiodothyronine (T3)
 Associated with autoimmune disease
o Pernicious anemia, MG, Type 1 DM
 Presentation
o Diffuse thyroid enlargement, exophthalmos, nervousness, tachycardia, and heat
intolerance
o Thyroid scan reveals a large “hot” gland with heterogeneous uptake

 Know the s/s of DM type one
The clinical presentation of type 1 DM includes all of the following except:

• Weight gain
• Ketosis
• Polydipsia
• Polyuria

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