Endocrine System 106

Considerations for the PT Assistant What will alter a pt's requirements for insulin?

Infection surgery physical/emotional stress

____ is utilized to manage Type 1 and possibly Type 2 Diabetes

Insulin Injection - Typically 1-4 injections are utilized daily into the arms, legs or abdomen and are coordinated with meals.

The ____ plays a critical role in controlling the metabolic rate of cells particularly the heart and respiratory rate as well as metabolism of fats, proteins and carbohydrates

thyroid gland

Considerations for the PT Assistant Too much ____ may increase calcium reabsorption and risk of osteoporosis as well as causing symptoms of palpitations, insomnia, nervousness

thyroid hormone

Considerations for the PT Assistant Low levels of ____ will result in fatigue, weakness, muscle cramps and memory loss

thyroid hormone

What is this used for? Glucophage.

to control blood glucose level. For Type 2 Diabetes -Medications to manage blood sugar levels are often taken from 1-3 times a day coordinated with meals

True False Insulin may also be used in Type II diabetics who do not attain normal blood glucose levels with diet and an oral hypoglycemic

true

If the pancreas does not secrete sufficient insulin to perform the above functions, the glucose level in the blood becomes high following ingestion of carbohydrates as it is not moved into the cells. This condition is known as _____

diabetes mellitus

____ is a disease in which insulin is either not present or is not appropriately secreted or acting.

diabetes mellitus.

Considerations for the PT Assistant * Patients should exercise during the peak phase of their glucose cycle, which is approximately ____ hours after eating.

2-3

Considerations for the PT Assistant True False Exercise has little to no effect on insulin absorption.

False - Exercise increases blood flow to the exercising muscles. If insulin had been administered by injection to that area, the increased blood flow will remove insulin faster from its site of injection. This means that the insulin many not be present later on when the patient needs it to move the glucose into their cells. Insulin administered before exercise should be injected into a non-exercising extremity or into the abdomen.

Considerations for the PT Assistant True False Exercise improves circulation and decreases glucose tolerance.

False - improves glucose tolerance

True False The liver produces Insulin

False -Insulin is a hormone secreted by the beta cells of the islets of Langerhans in the pancreas

True False Insulin can be injected or taken orally to manage Type 1 IDDM

False -Insulin must be injected rather than taken orally as the digestive acids in the stomach would destroy it rendering it ineffective in managing glucose levels. IDDM insulin-dependent diabetes mellitus, former name for type 1 diabetes mellitus.

Patients with _____ , will present with intolerance to cold, bradycardia, lethargy as well as other symptoms related to this slowing of the body's metabolism

Hypothyroidism

What is this used for? Levothyroxine, Synthroid

Hypothyroidism - The medications exactly replicate the hormone normally secreted by thyroid gland

Which type of Diabetes is this? since insulin may not be lacking, treatment may be accomplished with diet and/or an oral hypoglycemic.

Type II,

What is hyperglycemia?

subsequent rise in blood glucose levels - Condition characterized by excessively high levels of glucose in the blood, and occurs when the body does not have enough insulin or cannot use the insulin it does have to turn glucose into energy. Hyperglycemia is often indicative of diabetes that is out of control.

Although _____ is effective in managing osteoporosis, at the same time it may increase the risk of certain cancers, thrombophlebitis and cardiovascular disease

HRT Estrogen Hormone Replacement Therapy -HRT is associated with increased risk of stroke, DVT and breast cancer.

True False Insulin allows for storage of nutrients than can be released and utilized by the body in times of fasting.

True

True False Peripheral neuropathy also may lead to a loss of proprioception

True - Precise movement and placement of feet during ambulation may be lacking. This can lead to apparent gait deviations

True False Going barefooted is contraindicated for a diabetic patient.

True - because of the likelihood of foot injury. Prevention is overall much easier than treatment.

True False The body requires the insulin when the blood glucose is at its peak

True - timing of injections and meals must be coordinated

True False Autonomic neuropathy can cause postural hypotension

True - Avoidance of rapid changes in posture are necessary to prevent serious injury occurring from falls and fractures.

Considerations for the PT Assistant True False Exercise is very important to the total treatment of diabetes mellitus

True - Exercise causes a non-insulin-dependent glucose uptake. The patient should either reduce the dose of insulin if he knows that exercise will occur or else consume a glucose-containing food in order to prevent hypoglycemia from developing

Which Type of Diabetes requires replacement of insulin.

Type 1

Causes of _____ include: to much food consumption, too little insulin has been injected, stress, surgery or acute illness.

hyperglycemia

insufficient food consumption, too much insulin has been injected or increased physical activity can be a cause of ____

hypoglycemia -is literally translated as low blood sugar. Hypoglycemia occurs when blood sugar (or blood glucose) concentrations fall below a level necessary to properly support the body's need for energy and stability throughout its cells.

Considerations for the PT Assistant Do not exercise a patient just before a meal as their serum glucose will be low and the exercise may cause a ____ reaction.

hypoglycemic - Patients should prepare for possible hypoglycemia by eating a light snack prior to exercising.