Friday, October 28, 2011

Please help.. homework question that im struggling with.. what do you recommend about fluctuations of blood

Please help.. homework question that im struggling with.. what do you recommend about fluctuations of blood?
sugar and blood pressure.. pt is taking following meds : Aricept 10 mg daily, Zestril 10 mg daily, Glyburide 20 mg daily, MS Contin 15 mg tid pain. Pt has hypertension and diabetes mellitus.
Diabetes - 1 Answers
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1 :
We control diabetes with a combination of carb counting, portion control and diet, exercise and medication. There will be normal fluctuations in levels every single day.The goal is to keep in within a normal range. As I am not a doctor, I can not make medical decisions for others.






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Monday, October 24, 2011

What are foods that a diabetic person can eat

what are foods that a diabetic person can eat?
dietary management of diabetes mellitus
Diet & Fitness - 4 Answers
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1 :
At meals the person should eat a protein the size of a deck of cards & 2 carbs...go to the glycemic index if you want to find the best foods. I was overwhelmed & found that my blood sugar stays balanced when I just make sure I have protein but eat small meals. I will have half an apple with peanut butter or a half banana with peanut butte at 9 am & 3 pm to keep me steady then if I am hungry at night I might have popcorn or a low carb yogurt..the main thing it so test things & see how the person feels. I believe I have allergies so I had to stop eating so many things but I have done extremely well now with small meals.
2 :
Recommended Diabetic Food Intake: 1. Low Glycemic Index - doesn't create rapid peaks and troughs in blood glucose levels. 2. Complex high-fiber carbohydrates - Scientific evidence show that diet high in dietary fiber is protective against diabetes. Fiber is capable of slowing down the digestion and absorption of carbohydrate and increasing the sensitivity of tissues to insulin, thereby preventing rise s in blood sugar. It is advisable to restrict the intake of refined carbohydrates and avoid high fat foods. Example : Oats, cereals, legumes, wholegrain products, dried beans, peas, lentils, fruits, vegetables. 3. Alpha-lipoic acid - Is a vitamin like antioxidant that enhances the glucose uptake and improves diabetes nerves damage of diabetes patient. 4. Omega 3 - Protect against the hardening of arteries. Example : Cold water fish like salmon, tuna, mackerel, herring). 5. Omega 6 fatty acid - Protect against the development of diabetes neuropathy. Example : Blackcurrant oil, primrose oil, borage oil) 6. Artificial sweeteners - such as aspartame and saccharin. Restricted and to avoid : 1. Refined and simple carbohydrates - such as sucrose, glucose or fructose, white rice, white bread, table sugar, sweets, honey, corn-syrup. 2. High fat food. 3. Alcohol - Higher quantities alcohol can cause health problems like liver damage and increase the risk of heart disease. 4 High sodium food - such as salty fish.
3 :
A diabetic can eat anything as long as it is in moderation. For more details you should see a dietitian.
4 :
There is no one specific diet for diabetes, but people with diabetes should follow the following nutrition guidelines: Eat more starches such as bread, cereal, and starchy vegetables Add cooked black beans, corn or garbanzo beans to salads or casseroles Keep away from carbohydrates Eat five fruits and vegetables every day - Soluble fibers are found mainly in fruits, vegetables and some seeds Diabetic person should make life style changes. It will take a while to learn how to adjust to the changes in your diet and lifestyle. However, with regular practice and help, you can have a satisfying diet and keep your blood sugar under control, too.






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Thursday, October 20, 2011

Im confused..whats the difference between glycosuria, hyperglycemia, and what is their relation to diabetes

im confused..whats the difference between glycosuria, hyperglycemia, and what is their relation to diabetes?
mellitus
Biology - 1 Answers
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glycosuria = usually present in diabetics, it is the presence of glucose in urine, once your blood glucose level exceeds 180 mg/dL, glucose will start appearing in your urine. sometimes you also get glycosuria even if your blood glucose levels are normal and that is when your kidney tubules are abnormal. hyperglycemia = a clinical finding in diabetes mellitus characterized by a high glucose concentration in the blood, usually >110 mg/dL although diabetics have glucose concentrations higher than that which often exceeds 140 mg/dL even after 8 hours of fasting. both hyperglycemia and glycosuria are present in a diabetic person and these conditions can be tested in the lab






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Sunday, October 16, 2011

Question about swollen eyelids

Question about swollen eyelids?
My dad eyelids have swollen for a few days now. he indeed has a diabetes mellitus but no high blood pressure. his sugar rate(is it what it's called?) was about 121-200~ every time he checks. Are those swollen eyelids caused by his diabetes? Do you think he should go to the doctor? if yes, what doctor should he go? eyes, or kidney? Every answer is appreciated
Other - Diseases - 3 Answers
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1 :
It would be wise to get checked out by a doctor, especially if he has diabetes. Swollen eyelids can be caused by many things. Hay fever, allergies etc.
2 :
Your dad may have styes. It may or may not be related to diabetes. It can spontaneously resolve by itself. Ask him to see your family doctor, a GP. A GP will do for his condition.
3 :
Hi Hayley He should go to the doctor anyway. but it could related to heat.





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Wednesday, October 12, 2011

I have to make a case study on preeclampsia. below are the guidelines/examples.. pls help

i have to make a case study on preeclampsia. below are the guidelines/examples.. pls help?
I.Patient’s Profile General Data NameF.B. Age59 years old SexMale Civil StatusMarried OccupationHousewife History of Present Illness The patient has a known case of Rheumatic Heart Disease (RHD). Patient underwent Mitral Valve Repair (MVR) in 1999 and has been on Coumadin therapy with no regular follow up of bleeding parameters. Six days prior to admission, patient experienced headache and dizziness, but no consult was made. Instead, patient self-medicated with Bonamine which afforded relief. Three days prior to admission, headache persisted with increased severity, which prompted patient to seek medical assistance at FEU Hospital. Mobic and Iterax were given. Few hours prior to admission, patient was noted to have changes in sensorium and relatives decided to seek consult at Philippine Heart Center. Upon admission, patient was noted to be unresponsive, stuporous, and speechless, with GCS of 7 (E2V1M4). Past Medical History The patient has denies any history of Diabetes Mellitus and Hypertension. As mentioned, she had a history of Rheumatic Heart Disease and had Mitral Valve Repair in 1999. She is a non-smoker and non alcoholic drinker. Nursing Assessment (Problem-Based) Neurologic: LOC: drowsy to stuporous, 3-4 mm pupil size anisocoric, with brisk reaction to light; GCS – 9 (E4- Spontaneous eye opening V1- none/mechanical ventilation M4 – withdraws to pain) (+) doll’s eye reflex (+) babinski on right foot (-) corneal reflex, no visual threat Respiratory Patient is hooked to a mechanical ventilator through a tracheostomy. Ventilator set-up: 350/30/14/AC/5. (+) crackles on both lung fields. With equal breath sounds. Cardiac With atrial fibrillation; fine course, with occasional unifocal PVC’s. HR = 97 BP= 120’s-130’s/60’s-70’s. Musculo-Skeletal No contractures noted but there was stiffness noted at the right wrists and both ankle joints; with normal muscle tone and non-spontaneous movement; with severe weakness on both upper and lower extremities. Hematologic Latest PTPA: INR = 1.02 Act = 98% II.Anatomy and Physiology of the Brain Blood Supply of the Brain The blood supply of the brain derives from the aortic arch via the right innominate, left common carotid and left subclavian arteries. It includes the conducting and penetrating vessels. The venous system draining the brain is divided into vertebral veins that receive blood from the cerebellum. The cerebral veins have no valves. All the veins of the brain terminate into dural sinuses. External Brain Structures The brain is grossly divided into three main areas: the cerebrum, the brain stem and the cerebellum. The largest portion of the brain is the cerebrum. It consists of two hemispheres that are connected together at the corpus callosum. The cerebrum is often divided into five lobes that are responsible for different brain functions. The cerebrum’s surface—the neocortex—is convoluted into hundreds of folds. The neocortex is where all the higher brain functions take place. The cerebellum lies in the posterior fossa, separated from the cerebrum by tentorium cerebelli. It exerts ipsilateral control. It has three principal lobes. The Flocculonodular lobe is part of the vestibular system. It controls muscle tone, equilibrium and body position. The Anterior lobe receives most of the proprioreceptive and interoceptive input from head and body. It controls automatic movements and coordination. The posterior lobe coordinates voluntary movement. The ventricles The ventricles are a complex series of spaces and tunnels through the center of the brain. They secrete cerebrospinal fluid, which suspends the brain in the skull. They also provide a route for chemical messengers that are widely distributed through the central nervous system. Cerebrospinal fluid Cerebrospinal fluid (CSF) is a colorless liquid that bathes the brain and spine. It is formed within the ventricles of the brain, and it circulates throughout the central nervous system. It fills the ventricles and meninges, allowing the brain to “float” within the skull. The Meninges The meninges are layers of tissue that separate the skull and the brain. The Dura mater is the tough and fibrous membrane. The Arachnoid membrane is the delicate membrane and contains subarachnoid fluid. Pia mater is the vascular membrane. The subarachnoid space is fprmed by the arachnoid membrane and the pia mater. Normal Flow of Cerebrospinal Fluid Cerebrospinal fluid is produced in the Choroid plexuses of the ventricle. It flows from the lateral ventricles to the third ventricle passing through the interventricular foramen. Then it goes through the cerebral aqueduct to the fourth ventricle. From there fluid flows to the subarachnoid cisterns through the foramina of Magendie and Luschka to bathe the cerebral hemispheres. It exits through the saggital sinus to be absorbed by the arachnoid villi. III.Pathophysiology of Subarachnoid Hemorrhage (SAH) The term subarachnoid hemorrhage (SAH) refers to extravasation of blood into the subarachnoid space between the pial and arachnoid membranes. SAH comprises half of spontaneous atraumatic intracranial hemorrhages, the other half consist of bleeding that occurs within the brain parenchyma. Intracranial hemorrhage as a whole comprises 20% of all strokes. Nontraumatic SAH usually is the result of a ruptured cerebral aneurysm or AVM. Blood extravasation into the subarachnoid space has a detrimental effect on both local and global brain function and leads to high morbidity and mortality rates. The classic clinical picture of SAH is marked by the onset of very severe headache, tagged as the “worst in life”. Other associated signs and symptoms are loss of consciousness, seizures, diplopia and focal neurologic signs. The early complications of SAH are rebleeding and hydrocephalus. Other complications include vasospasm, neurologic deficits, hypothalamic dysfunction and hyponatremia. Vasospasm from arterial smooth muscle contraction is symptomatic in 36% of patients. Neurologic deficits from cerebral ischemia peak at days 4-12. Hypothalamic dysfunction causes excessive sympathetic stimulation, which may lead to myocardial ischemia or labile detrimental BP. Hyponatremia may result from cerebral salt wasting (SIADH). Nosocomial pneumonia and other complications of critical care may occur. Pathophysiology Diagram Pathological Cycle Resulting from Increased Intracranial Pressure Surgical Treatment Ventriculo-peritoneal Shunting The ventriculo-peritoneal shunt diverts CSF from a lateral ventricle or the spinal subarachnoid space to the peritoneal cavity. A tube is passed from the lateral ventricle through an occipital burr-hole subcutaneously through the posterior aspect of neck and paraspinal region to the peritoneal cavity through a small incision in the right lower quadrant. IV.Nursing Diagnoses 1.Ineffective Breathing Pattern r/t neuromuscular impairment 2.Ineffective airway clearance related totracheobronchial secretions 3.Altered Level of Consciousness r/t decreased cerebral perfusion 4.Impaired Physical Mobility r/t neuromuscular impairment 5.Risk for Injury r/t possible shunt malfunction 6.Risk for Infection r/t post-surgical wound V.Discharge Care Plan (METHODS) MEDICATION •Reinforce importance of medication compliance to patient and her relatives; its time, frequency, duration dosage and route. •Advice to report unusual manifestations and side effects of drugs to physician. •Monitor and evaluate effectiveness of medication regimen. ENVIRONMENT/ EXERCISE •Instruct patients watcher to provide calm and non stressful environment to prevent stimuli that could lead to seizures and an increase in Intracranial Pressure •Advice to limit visitors •Provide environment within normal room and body temperature. •Maintain safe environment. •Institute seizure precaution. •Initiate positional precaution to prevent increase in intracranial pressure. •Teach patient’s relative to perform passive range of motion exercises on patient’s extremities. TREATMENT •Teach patient’s relatives proper shunt care. •Teach patient’s relatives how to suction properly. HEALTH TEACHING ON DISEASE PROCESS •Explain to patient’s relatives regarding patient’s neurological status and disease process, and its manifestations. •Discuss possible complications of VP Shunt and its signs and symptoms OUT PATIENT FOLLOW UP •Inform relatives regarding importance of compliance on follow-up check up. •In case of continued Coumadin therapy, stress the importance of regular PTPA monitoring. Diet •Refer to dietician for dietary instructions. SPIRITUAL / SEXUAL •Encourage patient’s relatives to seek spiritual support. •Encourage patient’s husband on alternative ways on showing affections such as hugs and kisses. XI.Bibliography Nolte, J. The Human Brain: An Introduction to Its Functional Anatomy, Fifth Edition., Mosby, 2002. ISBN: 0-323-01320-1 Stoler, D. Coping with Mild Traumatic Brain Injury, Avery Penguin Putnam, 1998. ISBN: 0895297914 Human Anatomy and Physiology, Fifth Edition., 2000. ISBN: 0805349898. Zuccarello, M. and McMahon, N. “Subarachnoid Hemorrhage”. www.mayfield.com, June 2004. Rinkel GJ, Prins NE, Algra A. “Outcome Of Aneurysmal Subarachnoid Hemorrhage In Patients On Anticoagulant Treatment.” www.pubmed.gov, August 28, 2000. Newton, Todd R., Subarachnoid Hemorrhage. Emedicine from WebMD. www.emedicine.com., December 19, 2005.
Medicine - 3 Answers
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1 :
[quote] NameF.B. Age59 years old SexMale Civil StatusMarried OccupationHousewife [quote/] Is this Really a = Male ?? Nothing here pretains to preeclampsia, and Males sure don't get it. Preeclampsia happens sometimes during Pregnancy !!
2 :
YA is not the proper place to ask this. you NEED to READ. i can tell that you copied all this from the chart and books. and the only thing you did was the history and it's not even good. you need to work on that since how can you make your pathophysiology if you dont have proper assessment data to begin with? im sure you have MS and OB books
3 :
Males do not ever get pre-eclampsia, and you'd be hard-pressed to find it in a 59 year old. It is a disease of pregnancy. This question is unintelligible. If you have a REAL question, you'll get real help. You won't find anyone here willing to do your assignment for you.






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Saturday, October 8, 2011

I have 3 questions I need answered. Can you help me? Please

I have 3 questions I need answered. Can you help me? Please?
47. Which of the following is an example of a communicable disease? Alzheimer's disease common cold heart disease diabetes mellitus 48. Which of the following is NOT a reason it is difficult to cope with a chronic illness? financial obligations to cover treatment and care that health insurance may not cover loss of physical independence which requires more assistance with the activities of daily living knowledge that the person will get better with the appropriate medications dealing with depression and grief for the diagnosis 50. Which of the following is NOT a leading cause of death in the United States today? pneumonia heart attack stroke diabetes mellitus
Homework Help - 1 Answers
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1 :
Common cold, Knowledge that the person will get better, pneumonia






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Tuesday, October 4, 2011

A normal insulin level and absence of autoantibodies to islet cells in someone with chronic glucosurea is...

A normal insulin level and absence of autoantibodies to islet cells in someone with chronic glucosurea is...?
symptomatic of? a) Juvenile diabetes mellitus b) Type I diabetes mellitus c) Diabetes insipidus d) Type II diabetes mellitus e) None of the above I'm pretty sure it's NOT A, B, or C.
Biology - 1 Answers
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D is the correct answer.





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Saturday, October 1, 2011

Just a survey for my project.to all nursing student i need your answer to my question..

just a survey for my project.to all nursing student i need your answer to my question..?
questions: 1.a 20 yrs old female complain of dizzines naisea/vomiting and cut loss for month patient has a family Hx of dm(diabetes mellitus). a.whatcouldbe your primary diagnosis for the patient? b.as a nurse what is your dietary advise? c.nurse teaching you should give this patient? d.treatment consideration? 2.a 10 yrs old female complained of anterior neck mass, with easy patigability with loss, lab.work up, increase T3,T4,TSH enlarged thyroid.
Alternative Medicine - 1 Answers
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1 :
1. Oh my God. 20 years old. Too young. She must have consumed a lot of glucose during her childhood. Ok, the nursing diagnoses for this one is as follows; a> 1. Body image disturbed r/t gangrenous left foot(if there's any) 2. Hyperthermia r/t dehydration 3.Ineffective Therapeutic management r/t health beliefs Actually, there are a lot of NDx for this case. I wont tell you the primary NDx. The primary NDx for this should focus on the Diet plan, the management of the treatment, hygiene. Go figure that out. b.> Dietary advise? Ofcourse, less carbs like rice. Why? carbohydrates' end product is glucose. Protein should be taken 15-20% of kcal intake. Fats should be "low" in saturated fats. Fiber is good for DM. Sodium's recommended daily intake is 1000mg per 1000kcal, not to exceed 3000mg. To make the long story short: - moderately low carb intake - less salt intake(sodium) - less protein - Limit fat intake - Gradual increase in Fiber - Some suggest the use of Artificial Sweeteners, but for me it's a no no. Considering it could contain Aspartame, which have been found out to complicate DM. - NO ALCOHOL and SMOKING, please. c.> Again, proper diet, foot care, hygiene, proper diet, treatment management(insulin) d.> treatment considerations.this topic is too long, research on this one. 2. Did you mean easy fatiguability? question number two is incomplete and not constructed as it should be. please re-construct and put the questions, because there are no questions to answer this one. Thanks.






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