Gero study guide exam 3 pt2

What are the two main types of complications associated with diabetes?

Microvascular and macrovascular complications.

What are examples of macrovascular complications in diabetes?

Coronary artery disease (CAD), peripheral artery disease (PAD), and stroke.

What are examples of microvascular complications in diabetes?

Diabetic nephropathy, neuropathy, and retinopathy.

What characterizes macrovascular complications in diabetes?

They are diseases of the large and medium-size blood vessels that occur more frequently and earlier in people with diabetes.

How do microvascular complications arise in diabetes?

They result from thickening of the vessel membranes in capillaries and arterioles due to chronic hyperglycemia.

How do microvascular complications differ from macrovascular complications?

Microvascular complications are specific to diabetes, whereas macrovascular complications affect larger blood vessels.

What happens to the thyroid gland with age?

The thyroid gland atrophies and its activity decreases.

How does aging affect the basal metabolic rate?

Aging results in a lower basal metabolic rate.

What is the effect of aging on radioactive iodine uptake?

There is reduced radioactive iodine uptake with aging.

What happens to adrenocorticotropic hormone secretion with age?

Adrenocorticotropic hormone secretion decreases.

How does aging affect the adrenal gland?

It reduces the secretory activity of the adrenal gland.

What happens to the volume of the pituitary gland with age?

The volume of the pituitary gland decreases.

How is insulin secretion affected by age?

There is insufficient release of insulin by the B cells in the pancreas.

What happens to tissue sensitivity to insulin as people age?

Tissue sensitivity to circulating insulin is reduced.

How does aging affect the ability to metabolize glucose?

There is a reduced ability to metabolize glucose with age.

What is malnutrition?

Malnutrition is the disparity between the amount of food and nutrients that the body needs and the amount that the body is receiving.

What are the two types of malnutrition?

The two types of malnutrition are overnutrition (obesity) and undernutrition (malnourishment).

Do elders need more or fewer calories than younger adults?

Elders need fewer calories than younger adults.

What is a risk factor for malnutrition?

Obesity and dysphagia are risk factors for malnutrition.

What is constipation?

A decrease in frequency of bowel movements from the individual's 'normal'.

What is the normal frequency of bowel movements for any age?

3 times a day to 3 times a week.

What are common symptoms of constipation?

Painful defecation of hardened stools and persistent spasm of the rectum.

What is a common complaint associated with irritable bowel syndrome and inflammatory bowel disease?

The desire to empty the rectum due to persistent spasm.

What are some treatments for constipation?

Force fluids, prune juice, hot coffee or tea, leg exercises, ambulation, and increasing fiber.

What types of foods can help increase fiber intake?

Bran, fruits, and broccoli.

What are some medical interventions for constipation?

Laxatives, suppositories, enemas, and digital removal of fecal impaction.

What should be avoided in laxative use for constipation?

Mineral oil.

What is the purpose of a bowel training program?

To overcome inhibition of the gastrocolic reflex.

When should a bowel movement be encouraged during a bowel training program?

Immediately after the first meal of the day, usually breakfast.

What should be done if there is no bowel movement after breakfast?

Give an enema.

What should be kept during a bowel training program?

A log or chart of bowel movements, including number, consistency, and time.

When is bowel training usually successful?

By the 3rd to 5th day without rectal stimulation.

Can bowel training be done in cognitively impaired elderly patients?

Yes.

What is a nursing diagnosis related to constipation?

Risk for autonomic dysreflexia.

What is dysreflexia?

A life-threatening uninhibited sympathetic response of the nervous system to a stimulus after a spinal cord injury at T7 or above.

What are some signs and symptoms of dysreflexia?

Sudden elevated blood pressure, bradycardia or tachycardia, diaphoresis, red splotches on skin, pallor, headache, apprehension, and dilated pupils.

What is the most common type of colorectal cancer?

95% of colorectal malignancies are adenocarcinomas.

What is the typical 5-year survival rate for colorectal cancer?

The 5-year survival rate is low due to late diagnosis.

What are some risk factors for colorectal cancer?

Risk factors include being over the age of 65, family history, history of inflammatory bowel disease, a diet high in fat, protein, beef, and low in fiber, and a history of polyps.

What is a recommended dietary intervention before colorectal surgery?

A full liquid diet for 24-48 hours preoperatively.

What type of nutrition may be prescribed for colorectal surgery patients?

Parenteral nutrition may be prescribed.

What are some interventions for managing colorectal surgery patients?

Interventions include administering antibiotics, laxatives, enemas or colonic irrigations as ordered, and using a nasogastric tube.

What should be monitored in colorectal surgery patients?

Monitor for signs and symptoms of obstruction or perforation, including abdominal distension, high-pitched or loss of bowel sounds, pain, and rigidity.

What nursing diagnosis might be applicable for colorectal surgery patients?

Disturbed body image.

What should be done frequently during the first 24 hours post-surgery?

Examine the wound dressing for infection, dehiscence, hemorrhage, and excessive edema.

What is an important aspect of post-operative care for colorectal surgery patients?

Perform vital signs and pain assessments.

What is recommended after colorectal surgery to reduce recurrence?

Chemotherapy after surgery is recommended.

What type of support should be provided to colorectal surgery patients?

Provide emotional support and support for body image.

What is important to include in discharge teaching for colorectal surgery patients?

Discharge teaching should be provided.

What is an ostomy?

A surgical opening made within the abdominal wall to allow elimination of feces and urine.

What are common indications for an ostomy?

Cancer, IBD (Crohn's, UC), and abdominal penetrating trauma.

What is a colostomy?

An ostomy located at the end of the digestive tract.

What is an ileostomy?

An ostomy that bypasses the entire large intestine.

What is a urostomy?

An ostomy that allows for urine to be expelled.

What is the expected output for an ostomy?

Should always have more than 30 mL output per hour.

How should the skin around the ostomy be maintained?

It should be kept dry and clean.

What should be used if the skin around the ostomy is moist or eroded?

Use a barrier powder.

What color should the stoma be?

The stoma should be pink or red.

What colors indicate a problem with the stoma?

Pale, dark red, black, purple, or brown.

How should the ostomy appliance opening be sized in relation to the stoma?

It should be 1/8 inch larger than the stoma to prevent constriction.

What is diarrhea?

Frequent passage of difficulty to control loose, watery stools.

What are the two types of diarrhea?

Acute and Chronic.

What are some causes of diarrhea related to food?

Food intolerances, food poisoning, lactose intolerance, and alcohol.

What are some medical causes of diarrhea?

Medication side effects, long term antibiotic use, and excessive laxative use.

What bowel disorders can cause diarrhea?

Crohn's Disease and Irritable Bowel Syndrome (IBS).

What serious condition can lead to diarrhea?

Intestinal obstruction (fecal impaction).

What infections can cause diarrhea?

HIV/AIDS and bacterial infections like C. Difficile, salmonella, E. Coli, and giardia.

What are some symptoms of diarrhea?

Cramping, fever, green or yellow stools, mucous or blood in stools, frequent and runny stools, and bloating.

What are some treatments for diarrhea?

Discontinue medications, use bulking agents, avoid foods that cause diarrhea, and observe bowel sounds.

What should be done with antidiarrheals?

Use caution, as you want the body to rid itself of any infectious agent.

What is a potential emergency related to diarrhea?

Fluid and electrolyte imbalance.

What are some hydration options for diarrhea?

IV fluids or oral rehydration solutions like Gatorade or Pedialyte.