NR 601 Week 8 Exam Study Guide

Week Topics

 Qwivy | Qwivy.com | www.qwivy.com

Concept: endocrine

5 Glucose metabolism disorders

Types of diabetes (prediabetes, type 1 and type 2)

risk factors: most common ethnicity- caucasian, native american, Alaskan native men

and women.

Diagnostic criteria- FPG ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric

intake for at least 8 h.*

• 2-h PG ≥200 mg/dL (11.1 mmol/L) during OGTT. The test should be performed

as described by the WHO, using a glucose load containing the equivalent of 75-g

anhydrous glucose dissolved in water.*

• A1C ≥6.5% (48 mmol/mol). The test should be performed in a laboratory using a

method that is NGSP certified and standardized to the DCCT assay.*

• In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a

random plasma glucose ≥200 mg/dL (11.1 mmol/L).

Initial treatment recommendations- first line treatment for each type

Type 1- insulin

Type 2- 1

 Qwivy | Qwivy.com | www.qwivy.com

st line-lifestyle change, metformin

o common medication side effects- n/v/d/abd pain/anorexia/taste disturbancv

Treatment goals for older adults (Kennedy table 14-2) see picture

Hbg A1C goals based on complications (Dunphy p.925)- greater than/equal 6.5

Weight loss recommendations (Kennedy) to decrease risks related to diabetes

Risk factors- obesity, sedentary lifestyle, fam hx, HLD, sed life, HTN

Complications- diabetes is the leading cause of which complication? obesity

Treatments for complication

referrals- nutritionist, endocrinology hga1c >13, ophthalmologist,

Obesity

Comorbidities related to obesity- CAD, HTN, HLD, DM, CVA, central obesity

(abd), metabolic syndrome,osa, osteo, breast/colon/endometrial ca, kidney, liver,

esophagus, gastric, pancreatic, gallbladder, leukemia, dementia, ckd

o BMI classifications (Kennedy) see picture

6 Urology and aging (Kennedy)

Urinary incontinenceInvoluntary loss of urine from the bladder

▪ So common in women many consider it normal

▪ Common in older men w/ enlarged prostate

o Can affect quality of life

 Qwivy | Qwivy.com | www.qwivy.com

o Significance-One of the most common complains w/ older adults, Distress &

embarrassment, Cost burden to pt & society as a whole, Not life-threatening, may effect

QOL, PCP essential to educating individuals

o Epidemiology- Increased prevalence w/ age in men & women, Nursing home

population – 40-70%, Often a factor in placement

▪ URGENCY UI is greater in men

▪ STRESS UI is greater in women

o Terminology

▪ UI- Unintentional voiding, loss or leakage of urine

▪ Continuous incontinence-Continuous loss or leak of urine

▪ Increased daytime frequency-More frequent during day than considered normal

▪ Nocturia-Interruption of sleep one or more times due to the need to urinate – increases in

frequency after age 50

▪ Urgency-Sudden, compelling desire to pass urine that’s difficult to prevent

▪ Overactive bladder syndrome- Urgency, frequency, nocturia w/ or w/o incontinence

o Risk Factors-Aging,Obesity,Smoking, Caffeine,Uncontrolled DM, Constipation,Use of

diuretics

o Risk Factors by gender-Women:Aging, obesity, smoking, caffeine intake, DM,

pregnancy, multiparity, estrogen deficiency, hx of pelvic surgery, diuretics

Men:Aging, obesity, smoking, caffeine, DM, prostate dx, hx of prostate surgery, hx of

UTIs, diuretics

 Qwivy | Qwivy.com | www.qwivy.com