Nurs 2217 RDP Final

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Questions and Answers

What is the minimum A1c percentage that indicates diabetes?

5.0%

8.0%

6.5% (correct)

7.0%

Which of the following tests is most sensitive and can be used in early diabetes?

A1c testing

Glucose tolerance test (GTT) (correct)

Antibody testing

Lipid analysis

What is the recommended A1c goal for reducing risks of complications from diabetes?

8.5%

7.0% (correct)

6.0%

5.5%

Which condition may significantly alter A1c results?

Severe thalassemia Signup and view all the answers

What is indicated by a fasting insulin level test?

Quantity of residual insulin production Signup and view all the answers

What does a microalbuminuria level greater than 300 mcg/dL indicate?

Renal damage Signup and view all the answers

Which marker is associated with elevated levels in patients with diabetes during stress or infection?

C-reactive protein Signup and view all the answers

What reflects poor glycemic control and is often high with elevated glucose levels?

Triglycerides Signup and view all the answers

What is a common cause of hypoglycemia unawareness in patients with autonomic neuropathies?

Inability to sense low blood glucose levels Signup and view all the answers

Which symptom management is recommended for orthostatic hypotension in patients with autonomic neuropathies?

Using compression socks Signup and view all the answers

What is the most common type of retinopathy seen in diabetes patients?

Nonproliferative retinopathy Signup and view all the answers

Which action is suggested for gastroparesis in diabetic patients?

Frequent smaller meals Signup and view all the answers

What complication is likely to occur if macula is involved in proliferative retinopathy?

Vision loss Signup and view all the answers

What cardiovascular symptom is associated with autonomic neuropathies?

Resting tachycardia Signup and view all the answers

How many years after diagnosis do nearly all Type 1 diabetes patients show signs of retinopathy?

15 years Signup and view all the answers

Which of the following is a treatment for erectile dysfunction in patients with autonomic neuropathies?

PDE5 inhibitors Signup and view all the answers

Which gastrointestinal condition is commonly associated with autonomic neuropathies?

Constipation Signup and view all the answers

What is a potential visual symptom reported by patients with proliferative retinopathy?

Seeing black and red spots Signup and view all the answers

What is the primary objective of medication therapy in the management of pulmonary embolism?

Dissolve pulmonary embolisms and deep vein thrombosis Signup and view all the answers

Which of the following is NOT a method of preventing venous thromboembolism (VTE)?

Frequent hydration Signup and view all the answers

What type of medication does heparin represent in the context of thrombosis management?

Anticoagulant that prevents clot formation Signup and view all the answers

Which of the following supportive measures is essential in cardiopulmonary support for pulmonary embolism patients?

Turning and deep breathing exercises Signup and view all the answers

In an emergency situation where pulmonary embolism is suspected, what action should be taken immediately concerning treatment?

Start prophylactic anticoagulants as soon as possible Signup and view all the answers

What role does patient cooperation play in the management of pulmonary embolism?

It is necessary for medical therapies to be effective Signup and view all the answers

Which surgical option is primarily indicated if a patient is experiencing severe complications from a pulmonary embolism?

Thrombectomy Signup and view all the answers

What is one of the key objectives when preventing the growth or multiplication of clots?

Maintaining normal oxygen levels Signup and view all the answers

What is a common cognitive difficulty experienced by individuals with MS?

Short-term memory problems Signup and view all the answers

Which diagnostic test can help visualize plaques and atrophy in multiple sclerosis?

MRI of brain and spinal cord Signup and view all the answers

What is the primary goal of interprofessional care for patients with multiple sclerosis?

To decrease progression of the disease Signup and view all the answers

Which medication is often used to manage acute exacerbations of MS by reducing edema and inflammation?

Methylprednisolone Signup and view all the answers

What is a typical characteristic of multiple sclerosis at its early onset?

Vague symptoms that can go undiagnosed for a long time Signup and view all the answers

What characterizes the long-term cognitive function of individuals with MS?

General intellect remains unchanged Signup and view all the answers

Which type of therapy is recommended for managing fatigue in MS patients?

Amantadine Signup and view all the answers

What kind of pain management medication is commonly used for MS-related discomfort?

Antiseizure medications Signup and view all the answers

What is a potential complication that can lead to death in individuals with MS?

Pneumonia due to immobility Signup and view all the answers

Which of the following describes how multiple sclerosis affects nerve fibers?

Myelin is attacked while the nerve fiber remains intact. Signup and view all the answers

What is the role of immunomodulator medications in MS treatment?

To reduce the number of relapses and slow progression Signup and view all the answers

When monitoring a patient with only one lesion or clinical attack of MS, what should the interprofessional team do?

Continue regular monitoring Signup and view all the answers

Which of the following is a surgical intervention for treating multiple sclerosis symptoms?

Neurectomy Signup and view all the answers

Which dietary approach is mentioned as beneficial for individuals with MS?

Gluten-free diet Signup and view all the answers

What is the hallmark of hypertension related to systemic vascular resistance (SVR)?

Persistent increased SVR Signup and view all the answers

What is the role of insulin resistance in hypertension?

Stimulates sympathetic nervous system and renin-angiotensin-aldosterone system Signup and view all the answers

How does stress affect blood pressure control?

Leads to vasoconstriction and increased HR Signup and view all the answers

Which factors contribute to increased cardiac output in hypertension?

Early or borderline hypertension and normal later in the course Signup and view all the answers

What role does sodium and water retention have in blood pressure?

Low sodium intake shows little to no hypertension Signup and view all the answers

What is a common complication of hypertension related to the heart?

Hypertensive heart disease Signup and view all the answers

Which statement about endothelial cell dysfunction is correct?

Impairs the production of vasoactive substances Signup and view all the answers

What percentage of blood pressure variability is attributed to genetic factors?

30-60% Signup and view all the answers

What is one common form of abuse that men are more likely to perpetrate?

Exploitive abuse Signup and view all the answers

What type of neglect involves the failure to provide essential needs to a vulnerable elder?

Neglect Signup and view all the answers

Which of the following situations may indicate self-neglect?

An elderly person being isolated socially Signup and view all the answers

Which type of elder abuse is characterized by the desertion of a vulnerable elder?

Abandonment Signup and view all the answers

What factors contribute to poor interpersonal relations among the elderly?

Invisibility to society Signup and view all the answers

Which characteristic is NOT commonly associated with self-neglect in the elderly?

High economic resources Signup and view all the answers

What type of neglect occurs when both individuals in an older married couple neglect each other?

Mutually neglectful Signup and view all the answers

Which of the following is a psychological risk associated with self-neglect?

Hoarding behavior Signup and view all the answers

Study Notes

Mobility/Functional Ability in Parkinson's and MS

Functional Ability Definition: The ability to perform typical daily tasks, fulfill roles in family/work/community, and maintain well-being. Includes cognitive, social, physical, and emotional abilities.
Functional Ability Scope: Varies significantly between individuals and even within the same individual over time. Considers lifespan where developmental milestones are important and environmental/lifestyle changes impact ability.
Attributes and Criteria: Functional ability has two dimensions: attributes (defining characteristics) and antecedents (requirements before functional ability exists). Antecedents include capacity, actual or required performance, physiological processes, developmental milestones, and skills influenced by social, environmental, and cultural factors.
Context to Nursing and Health Care: Three major dimensions of concern are risk recognition, resource utilization (support), and health outcomes. Early identification of factors affecting function is crucial.
Risk Recognition: Identifying factors impacting functional ability is essential for early resource allocation and better health outcomes. Early identification of deficits improves outcomes. Forms of risk include developmental delays, comorbidities, stressors, etc.

Functional Assessment

Functional Assessment Methods:
Self-Reports: Patients' perceptions of their function are valuable but may be inaccurate due to personal biases, preferences, and how the environment affects their perception.
Performance-Based Assessments: Actual observation of a standardized task provides an objective measurement of functional ability, although it can be affected by personal characteristics and environmental factors influencing interpretation. Use of tools relevant to the age and situation of the individual.

Planning and Delivery of Individualized Care for Functional Ability

Care Delivery: Individualized care must be provided based on the exact needs of the individual for proper support for independence.
Alterations: Abilities can change due to primary or secondary issues. Primary issues involve impairments from the onset, while secondary problems involve loss of function as a result of other factors.

Pathophysiology of Parkinson's Disease

Parkinson's Disease: A neurological disorder caused by the loss of dopamine-producing neurons in the substantia nigra of the midbrain.
Symptoms: Gradual onset, including tremors (most often at rest), rigidity (resistance to passive movement), akinesia (difficulty initiating movement), and postural instability (risk of falls).
Risk Factors: Well water exposure, pesticides, herbicides, certain industrial chemicals, and a potential genetic component are factors linked, although exact cause is unknown.
Additional Symptoms: Other symptoms include depression, anxiety, memory problems, sleep disturbances, pain, and constipation

Medical Nursing Management

Medical Therapies:
- Correcting Imbalance: Meds focus on correcting the imbalance of acetylcholine and dopamine in the central nervous system (CNS).
- Dopamine Precursor: Levodopa/carbidopa helps in increasing dopamine and prevents breakdown in peripheral tissues.
Other treatments: Other medications include Pramipexole (Mirapex), Rotigotine (transdermal patch), and anticholinergics to decrease acetylcholine activity.
Surgical Therapy:
- Ablation: Stereotactic destruction of specific brain areas like thalamus (thalamotomy), globus pallidus (pallidotomy), and subthalamic nucleus (subthalamic nucleotomy) are used. DBS is a replacement for some ablative surgeries.

Multiple Sclerosis

Pathology: A chronic, progressive autoimmune disorder affecting the central nervous system (CNS). Signs and symptoms involve the demylination of nerve fibers in the brain and spinal cord.
Symptoms: Include motor, sensory, and bowel/bladder impairments. Initially, symptoms are often subtle in nature and include numbness and tingling in an extremity.
Causes: Although the exact cause is unknown, genetic susceptibility, infection, or environmental exposure appear to play a role in the development of MS.

Tissue Integrity

Assessment: Includes wound measurement, tissue evaluation, location, exudate, temperature, infection, and periwound skin characteristics.
Actions to Prevent Infection: Includes proper healing procedures as well as promoting proper nutrition, hydration and other supporting measures.

Sensory Perception

Glaucoma: An eye condition causing elevated intraocular pressure (IOP), damaging the optic nerve and leading to vision loss.
Types of Glaucoma: Primary open-angle glaucoma (most common), primary angle-closure glaucoma.
Diabetic Neuropathy: Nerve damage associated with diabetes, affecting various organs and body functions. Symptoms may affect vision, autonomic functioning, sensory functions, and motor skills.
Peripheral Neuropathy: A condition causing damage to nerves outside the brain and spinal cord. It may manifest as numbness, tingling, and pain, usually in the hands and feet.

Hormonal Regulation: Hypothyroidism

Definition and Description: The process responsible for maintaining proper hormone levels in the body.
Patho, Clinical manifestations, and Medical Management: The mechanisms, symptoms, and treatments for hypothyroidism are covered.

Technology and Adherence

Benefits of Technology in Home Settings: The advantages of utilizing technologies for home monitoring or other healthcare-related tasks.
Challenges of Maintaining Adherence: Factors that may affect adherence to treatment regimens, including medications, or other care.

Perfusion

Normal Peripheral Blood Flow: The physiology of maintaining proper blood flow, including coagulation and factors that impact blood flow.
Venous Thromboembolism: Disruption of the flow and clotting resulting from blood clots in the deep veins, leading to potential pulmonary embolism complications.
Peripheral Vascular Disease: Conditions causing problems with circulation in the blood vessels outside the heart and brain, including atherosclerosis, inflammation, and injury complications.

Pain Management

Perception of Culture: Discuss the impact of an individual's cultural beliefs on their perception of pain.
Management: Includes various types of pain management techniques, including those related to physical modalities, psychological help, and medications.
Types of Pain: Categories of pain based on mechanisms, such as nociceptive and neuropathic pain.

Healthcare Law & Interpersonal Violence

Health Care Laws & Privacy: The importance of HIPAA and the need for appropriate reporting and the role of nurses in relation to laws related to healthcare and privacy.
Protection for Persons in Care Act: Focuses on defining types of elder abuse, factors/risk factors, and the duty to report.
Elder Abuse: The concept includes different forms of abuse, psychological/emotional, physical, financial, and sexual abuse, and neglect. This section discusses the associated risk factors and prevention strategies.

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Description

This quiz tests your knowledge on critical aspects of diabetes management, including A1c levels, tests, and complications associated with diabetes. Examine your understanding of various indicators and treatment recommendations for effective diabetes care.