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NR 325 Exam 1 Study Guide with Complete Solutions

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NR 325 Exam 1 Study Guide with Complete Solutions Endocrine System Function - Answer-Produce hormones and secrete them directly into the bloodstream Insulin - Answer-Regulator of metabolism and storage of ingested carbohydrates, fats, and proteins (anabolic or storage hormone). Facilitates gl...

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NR 325 Exam 1 Study Guide with
Complete Solutions

Endocrine System Function - Answer✔✔-Produce hormones and secrete them directly into the

bloodstream

Insulin - Answer✔✔-Regulator of metabolism and storage of ingested carbohydrates, fats, and proteins

(anabolic or storage hormone).

Facilitates glucose transport across cell membranes

Counterregulatory Hormones - Answer✔✔-Oppose the effects of insulin, and increase blood glucose

levels. They provide a regulated release of glucose for energy, and help maintain normal blood glucose

levels.

Ex: glucagon, epinephrine, growth hormone, cortisol

Glucagon - Answer✔✔-Normally produced by pancreatic alpha cells when blood sugar is low to raise

blood glucose levels. In diabetes II, glucagon is still produced, but because there is so much insulin, our

pancreas doesn't respond normally.

Diabetes Mellitus - Answer✔✔-A chronic, multi-system disease related to abnormal insulin production,

impaired insulin utilization, or both. There is no cure, but diabetic complications can be delayed or

prevented with good management. African Americans, Hispanic/Latino Americans, and Native Americans

have a higher incidence of diabetes.

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Diabetes Complications - Answer✔✔-Diabetes is the leading cause of adult blindness, end-stage renal

failure, and non-traumatic lower limb amputations. It is also a major contributing factor to heart disease

and stroke.

Gerontologic Considerations with Diabetes - Answer✔✔-Diabetes prevalence increases with age related

to reduced B-cell function, decreased insulin sensitivity (!!), and altered carb metabolism. Undiagnosed

and untreated diabetes is more common in older adults, partly due to the normal physiologic changes of

aging resembling that of DM.

Diabetes is present in at least 25% of people over age 65.

Diabetes Type I Epidemiology - Answer✔✔-Formerly known as "juvenile onset" or "insulin dependent"

diabetes.

Most often occurs in people under 40 years old, and accounts for 5-10% of all people with diabetes.

Has a sudden onset.

It is an autoimmune disease, in which B-cells responsible for insulin production are destroyed. A genetic

predisposition and exposure to a virus are factors that may contribute to the development of DM I.

Autoantibody are produced and destroy B-cells. Manifestations occur after the pancreas is unable to

produced insulin, and symptoms are rapid. Usually patients present to ER with DKA.

Diabetes Type I Classic Symptoms - Answer✔✔-Polyuria

Polydipsia

Polyphagia

Weight loss

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Prediabetes - Answer✔✔-Known as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).

Prediabetes Labs - Answer✔✔-IFG: fasting glucose levels 100-126 mg/dl

IGT: 2 hour plasma glucose 140-199 mg/dl

A1C: in the range of 5.7-6.4%

A1C Lab - Answer✔✔-It is a test that determines how well your glucose was stabilized within the last

three months.

If you have a high A1C, that means you have had high glucose levels in the last 3 months

Diabetes Type II Etiology - Answer✔✔-Probably has a genetic basis.

A genetic mutation leading to insulin resistance, and as the disease progresses, less insulin production.

There is also an increased risk for obesity.

Obesity is the most powerful risk factor, especially obesity with an increased waist circumference.

Type II DM is now being seen in children due to epidemic of childhood obesity.

Type II accounts for 90% of diabetics.

Pancreas continues to produce insulin, but the body can't use the insulin.

Diabetes Type II Risk Factors - Answer✔✔-Obesity

Aging

Sedentary lifestyle

Family history of Type II DM

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Urbanization

Certain ethnicities (AA, NA, Latino)

Diabetes Type II Clinical Manifestations - Answer✔✔-Nonspecific symptoms, may have classic symptoms

of type I

Fatigue

Recurrent infections

Recurrent vaginal yeast or monilia infections

Prolonged wound healing

Visual changes

The onset of symptoms is gradual.

Diagnosing Diabetes: Fasting Plasma Glucose Level - Answer✔✔->126 mg/dl

Fasting is no caloric intake for at least 8 hours. The FPG test needs to be confirmed by repeating testing

on another day.

Diagnosing Diabetes: Random Plasma Glucose Measurement - Answer✔✔->200 mg/dl plus symptoms

Diagnosing Diabetes: Two-Hour OGTT Level - Answer✔✔->200 mg/dl using a glucose load of 75g.

You have the patient drink a syrup drink and evaluate how well the body tolerates large doses of sugar.

Diagnosing Diabetes: Hemoglobin A1C Test - Answer✔✔-Useful in determining glycemic levels over time.

May be used in diagnosis or to monitor success of treatment. It shows the amount of glucose attached to

hgb molecules over RBC life span (3 months). <6.5-7%

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