Term
| List normal values for pre-albumin. What is it a measure of? |
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Definition
short-term gauge of nutrition
20-40 mg/dL
<15 = malnutrition |
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Term
| List normal values for albumin. What is it a measure of? |
|
Definition
3.5-5.5 g/dL - long-term gauge of nutrition
malnutrition = <3.5 |
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Term
| What are normal levels for fasting glucose? What does it indicate? |
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Definition
70-115 mg/dL
short-term management of diabetes |
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Term
| What are normal values for HbA1c? What is it? What does it indicate? |
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Definition
4-6%; >7 indicative of diabetes
glycosylated hemoglobin - determines the amount of plasma glucose concentration over a period of time |
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Term
| When is a melanoma of concern? |
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Definition
| diameter >6 mm (bigger than a pencil eraser) |
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Term
| List 3 treatment modalities used to promote wound healing. |
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Definition
iontophoresis with zinc or histamine
ultrasound (low intensity, pulsed, 3x/wk)
E-stim - HVPC most commonly used; no side-effects & shows wound healing in RCT's, also low-voltage continuous direct current but has potential to harm patient |
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Term
| With e-stim for wound healing, what do the anode & cathode do? |
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Definition
anode (positive pole) - promotes epithelial cell migration & reactivation of inflammatory phase
cathode (negative pole) - promotes granulation, controls inflammation, & inhibits certain bacteria. |
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Term
| Differentiate between a primary, secondary, and tertiary union. |
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Definition
primary - healing that takes place following a non-infected laceration or surgical excision - no major loss of connective tissue - seals by blood clot within hours
secondary - prolonged process of dermal healing that results from necrosis or tissue due to inflammation or traumatic destruction (decubitus ulcer healing) - delay of wound healing unless dead tissue & debris are removed from wound - moist wound healing should be promoted except with infection
tertiary - a delay in suturing of a site for 5-7 days is indicated in the presence of wound contamination, large tissue loss, or excessive edema - expected to close via primary union after delayed closure |
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Term
| For arterial insufficiency ulcers, a person with an ABI <____ will not be able to have their wound heal without medical interventions. |
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Definition
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Term
| Where are venous and arterial ulcers usually found? |
|
Definition
venous - medial malleolus
arterial - lateral malleolus & bottom of foot |
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Term
| Diabetic foot ulcers are scored using the ______ scale. |
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Definition
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Term
| T/F. It is acceptable to use pressure ulcer staging for diabetic ulcers. |
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Definition
| False - need to use Wagner scale |
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Term
| Thyroid function is regulated by the _________ & ________ feedback controls, as well as in intrinsic regulatory mechanism within the gland itself. |
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Definition
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Term
| Hypothyroidism is diagnosed if TSH is ______. |
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Definition
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Term
| Hyperthyroidism is diagnosed if TSH is _______. |
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Definition
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Term
| Hyperthyroidism occurs in countries where ______ is sufficiently present in the diet. |
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Definition
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Term
| parathyroid hormone regulates ____ & ____ metabolism. |
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Definition
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Term
| What occurs with Hyperparathyroidism? |
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Definition
| elevated serum calcium level & decreased serum phosphate level - causes demineralization of bone & subsequent loss of bone strength & density - causes glove/stocking sensory loss, fractures, confusion, memory loss, osteitis fibrosa cystica (bone lesions called Brown tumors) |
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Term
| What occurs with Hypoparathyroidism? |
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Definition
| decreased or absent production of PTH - decreased serum calcium level & increased serum phosphorus level - causes muscle cramps, seizures, irritability, arrythmias, paresthesias, & Chvostek's sign (twitching of facial muscles with tapping of the facial nerve in front of the ear |
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Term
|
Definition
| twitching of facial muscles with tapping of facial nerve in front of the ear |
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Term
| List values for hyper & hypoglycemia. |
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Definition
hyper = >180
hypo = <50-60 |
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Term
| List MACROvascular disease complications of diabetes. |
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Definition
cerebrovascular disease
CAD
renal artery stenosis
PVD |
|
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Term
| List MICROvascular complications of DM. |
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Definition
| retinopathy, nephropathy, decreased microcirculation to skin/organs |
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Term
| Where should patients with diabetes aim to keep their glucose levels? |
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Definition
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Term
| What should you do if a patient is supposed to exercise and their glucose levels are <70, 70-100, or >250? |
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Definition
70 - give carbohydrate snack, wait 15 minutes, and re-test blood sugar
70-100 - administer carbohydrate snack during exercise if any symptoms of hypoglycemia occur
>250 - do not exercise until blood sugar comes down. |
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Term
| Gout primarily affects what joints? What is the treatment? |
|
Definition
peripheral joints of the hand, metatarsophalangeal joint of the great toe, instep, ankle, heel, knee, & wrist
urate lowering drugs such as colchicines, NSAIDS, steroids, or allopurinol to reduce hyperuricemia |
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Term
| Define hemochromatosis & list symptoms. |
|
Definition
excessive absorption of iron by the small intestines - causes irreversible damage to heart, liver, pancreas, endocrine glands, joints, bone & skin
- causes arthralgias, arthropathy, myalgias, weakness, pitting edema, hyperpigmentation of the skin, CHF, loss of body hair, & DM |
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Term
| What shows up on x-ray examination of transverse, fracture-like lines in affected bones? |
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Definition
| Osteomalacia - Vitamin D deficiency causes softening of bones |
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Term
| Osteomalacia in children is known as _____. |
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Definition
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Term
| Osteomalacia presents itself at the ______ ends of long bones as well as the sternal ends of the _____. |
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Definition
| metaphyseal; ribs (rachitic rosary) |
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Term
| What is the presentation of Paget's disease? |
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Definition
| bone is large, less compact, & more susceptible to fracture - bones most commonly affected are the skull, pelvis, spine, sacrum, femur, & tibia |
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Term
| What organ produces albumin & plasma proteins? |
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Definition
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Term
| Which disease causes light-colored (clay) stools, dark urine, & skin changes? |
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Definition
liver
light colored stools could also be from pancreatic cancer |
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Term
| What disease can be a consequence of liver failure due to statin use? |
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Definition
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Term
| Intolerance of fatty foods, excessive belching and flatulence, jaundice, & low grade fever indicate what disease? |
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Definition
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Term
| Sudden exacerbation of gall-bladder symptoms after eating indicates_____, while pain & nausea 1-3 hours after eating indicates ______. |
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Definition
gallbladder inflammation
gallstones |
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Term
|
Definition
| presence or formation of gallstones. |
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Term
| Differentiate between biliary colic, cholecystitis, & cholangitis. |
|
Definition
biliary colic - neck of gallbladder - R upper quadrant pain that comes & goes in waves
cholecystitis - cystic duct
cholangitis - common bile duct - can cause liver infection |
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Term
| List examples of antacids. |
|
Definition
| Mylanta, Maalox, Tums, Rolaids |
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Term
| List examples of H2 receptor blockers. |
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Definition
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Term
| List examples of proton pump inhibitors. |
|
Definition
| Prilosec, Prevacid, Nexium |
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Term
| Clients with nocturnal reflux should be instructed to sleep on their _____ side. Why? |
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Definition
| L - prevents regurgitation & aspiration |
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Term
| Stomach ulcer pain is ________ with the presence of food. |
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Definition
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Term
| Which condition has bright red or coffee ground vomitus, in addition to dark, tarry stools? |
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Definition
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Term
| List symptoms of colorectal cancer. |
|
Definition
persistent change in bowel pattern , rectal bleeding, abdominal/pelvic/back/saral pain, diarrhea, constipation
advanced stage: constipation leading to obstipation, diarrhea with copious amounts of mucous, nausea, vomiting, weight loss, fatigue, dyspnea |
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Term
| Renal & ureteral pain is felt throughout the ___ & ___ dermatomes. |
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Definition
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Term
| Urge incontinence is usually due to ______ overactivity. What else can cause urge incontinence? |
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Definition
detrusor
urethral instability, medications, infection, bladder tumors |
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Term
| It is a red flag if ______ occurs at the same time urinary incontinence develops. |
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Definition
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Term
| It is a red flag if ________ pain is accompanied with abnormal urinary constituents. |
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Definition
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|
Term
| How many weeks are in each of the three trimesters? |
|
Definition
1st - 12
2nd - 13-26
3rd - 27-40 |
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Term
| List normal weight and length for a full-term infant. |
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Definition
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|
Term
| T/F. It is normal for mild bleeding to persist 3-6 weeks after delivery of a baby. |
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Definition
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Term
| List changes to RR, TV, O2 consumption, & dyspnea with pregnancy. |
|
Definition
unchanged; depth of respiration increases
TV - increased
15-20% increase in O2 consumption (natural state of hyperventilation throughout pregnancy)
Dyspnea present with mild exercise as early as 20 wks d/t increased work of breathing from hyperventilation. |
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Term
| What should you do to reduce the effect of vena cava syndrome? |
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Definition
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Term
| What should you do if a pregnant mother experiences a sudden increase in BP? |
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Definition
| medical emergency - mother may be experiencing pre-eclampsia - get medical help |
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Term
| The fasting blood glucose level in pregnant women is usually _____ than in non-pregnant women. |
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Definition
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Term
| How do you test for diastasis recti? |
|
Definition
| Patient in hook-lying position - have patient slowly raise head & shoulders off of the floor, reaching hands towards knees, until the scapula leaves the floor - therapist places the finger of one hand horizontally across the midline of the abdomen at the umbilicus - diastasis is measured by the number of fingers that can be placed between the rectus muscle bellies |
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Term
| What exercises are acceptable for women after childbirth with a diastasis less than 2 cm (2 finger widths)? |
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Definition
| head lift, head lift with pelvic tilt, & pelvic floor (Kegels) exercises - no double leg lifts, quadraped, leg lowering, or curl ups until diastasis recti has fully resolved |
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|
Term
| What is a typical post-cesarean exercise program? |
|
Definition
| diaphragmatic & upper chest breathing, pelvic floor exercises, & pelvic mobility exercises |
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Term
| The maternal hematocrit level during pregnancy is _____. What happens during exercise? |
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Definition
| lowered - increases 10 percentage points within 15 minutes of vigorous exercise |
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Term
| Compression of the IVC by the uterus can occur after the ______ month of pregnancy. |
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Definition
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|
Term
| T/F. Hypoglycemia occurs more often during pregnancy. |
|
Definition
| True - need adequate carbohydrate intake when exercising pregnant women |
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Term
| Studies indicate the core temperature of physically fit women is ______ during exercise. Why is this fact important for pregnant women? |
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Definition
| decreased - if pregnant women are fit, can reduce thermal stresses to fetus. |
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Term
| List 7 contraindications to exercise for pregnant women. |
|
Definition
incompetent cervix - early cervical dilation before full-term pregnancy
vaginal bleeding
placenta previa - placenta in a position where it may detach before the baby is delivered.
rupture of membranes - loss of amniotic fluid prior to onset of labor
premature labor (before the 37th week)
maternal heart disease
maternal diabetes |
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Term
| Are diastasis recti & uterine contractions contraindications or precautions to exercise? |
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Definition
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|
Term
| What are the 3 leading causes of death for obese people? |
|
Definition
| CV disease, diabetes, & CA (hormone-related breast, cervical, liver, endometrial, prostate, colon) |
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|
Term
| Define hooklying, Fowler's, & Semi-fowler's positions. |
|
Definition
hooklying - supine with knees & hips bent up with feet flat on bed
Fowler's - HOB elevated to 60-90 deg.
Semi-Fowler's - 45-60 |
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Term
| List aerobic exercise parameters for obese individuals. |
|
Definition
start at 50% max HR - use a RPE to monitor
begin at 20 minute sessions which may be broken up
build to 60 minute session broken into 10-15 minute segments
progress to 4-6x/wk & incorporate activities into the 2-5 MET range |
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Term
| Describe resistance exercise parameters for obese individuals. |
|
Definition
start at 30-40% 1RM
start at 1-2 sets of 15-20; incorporate 3-10 types of exercise - progress to a 30 minute session of resistance exercises - perform resistance on non-consecutive days up to a max of 4 days/wk
incorporate resistance with circuit training for aerobic benefit. |
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Term
| Describe precautions for a patient with a shunt. |
|
Definition
| no head down positioning - increases ICP |
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|
Term
| 1st sign of arterial disease is often _____. |
|
Definition
| loss of hair on the toes - cyanosis comes in later chronic disease |
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|
Term
| Pressure ulcers have _____ skin temperature as compared to surrounding tissue. |
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Definition
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|
Term
| Radiation therapy can cause what? |
|
Definition
| adhesions in skin - can restrict motion d/t pain & require stretching |
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|
Term
| Who is most appropriate to use the 6 min. walk test for a measure of endurance? |
|
Definition
| acutely ill cardiopulmonary patients |
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