NURS 5433 DIABETES NEW EXAM WITH 100% VERIFIED SOLUTIONS

NURS 5433 DIABETES NEW EXAM WITH 100%
VERIFIED SOLUTIONS

How to dx metabolic syndrome?
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• When 3 or more of the following 5 criteria are present—
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then patient has Metabolic Syndrome [CDC, 2021]
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-Waist circumference—men >40
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-Triglycerides >150 mg/dL WS WS




-HDLW S cholesterol—men W S <40 mg/dL; women <50 mg/dL
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-Blood Pressure >130/85
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-FBS >100 mg/dL
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What else can we call metabolic syndrome?
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• Also known as:
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-Insulin Resistance Syndrome
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-Cardiovascular Dysmetabolic Syndrome WS WS




-ICD-10 Code is E88.81
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and should be listed as a DX
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Acanthosis Nigricans WS




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Hyperkeratotic condition, diffuse hyperpigmented velvety thickening of the cutane
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ous skin of neck and axillae
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-1st visible sign is darkening of the skin, so that it appears dirty
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-Eventually, this skin becomes rugose and mamillated
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,ndiagnositcs for metabolic syndrome:
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• It is a clinical diagnosis—assess:
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• BMI

• Waist circumference
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• Fasting HDL & trigs
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• Microalbumin

• Uric acid level
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• Some diagnostics can be used [ordinarily not needed]
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-Fasting plasma insulin level
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-If level >10 mcg/ml indicates IR
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-
Elevated insulin levels with a normal glucose level is the hallmark of insulin resistanc
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e

-Not usually measured in primary care
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differential diagnosis of metabolic syndrome:
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• Type II Diabetes
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• Prediabetes

• Polycystic Ovarian Syndrome
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• Genetic SyndromesWS




-Down's Syndrome W S




-Turner's Syndrome WS




-Muscular Dystrophies WS




management of metabolic syndrome: WS WS WS




• Pharmacologic interventions WS




-Antihypertensives

, -Statins

-ASA per guideline and those with CHD/CV disease
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-Possibly Metformin W S




-Can reduce possibility of diabetes by 38%
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-But, good lifestyle changes can reduce possibility of diabetes by 58!!!!
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ACEI and ARBs do not worsen insulin resistance or lipid profiles and offer renal
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protection [Considered DOC for these patients]
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** do not use beta blcokers--worsen IR and decrease glucose uptake by 25-37%
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cholesterol goals T WS WS




rig. <150 WS




LDL <100 WS




HDL >40 mg/dl men, >50mg/dl women (wt loss, stop smoking, vigorous excersice
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increa. HDL) WS




ASA THERAPY FOR MEN >55 FOR
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MI RISK IN WOMEN >65 FOR CV
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A



IR is the pathophy. hallmark of IGT and type 2 DM
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Review prevalence trends for diabetes in the U.S. with emphasis on different racial
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and ethnic groups.
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o High risk groups: Native American, Black, Hispanic = highest risk
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o High risk in obese population
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Identify at least 5 risk factors for diabetes.
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o Sedentary lifestyle WS