Physiological Integrity Practice Quiz 7

Insulin is produced by the beta cells of the pancreas. In type 1 diabetes, the pancreatic beta cells are destroyed by an auto-immune process. The patient loses the ability to produce insulin and must rely on injections to survive. There is currently no cure for type 1 diabetes. It requires intensive life-long medical management to control the blood glucose level.

A colostomy is created when the bowel is pulled through an opening in the abdominal wall, creating a stoma through which intestinal contents will pass. A healthy stoma will protrude about 2.5 cm with an open lumen at the top. The stoma should appear pinkish-red and moist. A dry, dusky, or reddish purple stoma indicates ischemia. A narrowed, flattened, or constricted stoma indicates stenosis. A concave and bowl-shaped stoma has retracted. A retracted stoma can be difficult to care for.

Because the bone marrow is not making an adequate amount of red blood cells and platelets, the patient will experience fatigue due to anemia, and bruising due to decreased platelets. Bone pain is caused by the stretching of the periosteum because of the excessive white blood cells. The CBC may show increased blasts, or immature white blood cells, crowding out the normal RBCs and platelets.

Antibiotics must be not be started until a blood culture test is drawn, as administering antibiotics may interfere with identifying the bacteria and the appropriate therapy. The blood count will reveal the presence of infection but does not help identify an organism or guide antibiotic treatment. Parental presence is important for the adjustment of the child, but not for the administration of medication.

Infection causes a stress response in the body by increasing hormones glucocorticoids and epinephrine, which suppress the natural immune response. These stress hormones work against insulin and cause an increase in blood glucose levels. With high glucose levels, white cells are slowed and take more time to fight the infection. Type 2 diabetics may temporarily require insulin during acute illnesses and hospitalizations.

Chronic hypoxia, from reduced air exchange, leads to low oxygen levels in the body. The kidneys respond to chronic hypoxia by releasing erythropoietin, which stimulates red blood cell production. The red blood cell count is elevated to compensate for the hypoxia, or low oxygen levels. More cells are available to carry and deliver the maximum amount of oxygen.

Type 1 diabetes is characterized by hyperglycemia secondary the body's inability to create insulin. Corticosteroids cause a rise in blood sugar even in a non-diabetic patient by increasing insulin resistance and triggering the liver to release additional glucose. Changes in sodium, albumin and potassium would not be expected findings in this scenario.

A patient with Addison’s disease (adrenal insufficiency) requires normal dietary sodium to prevent excess fluid loss and maintain electrolyte balance. Adequate caloric intake is recommended with a diet high in protein and complex carbohydrates, including grains.

A patient is considered to have hypertension even if one of the parameters ( either diastolic or systolic) is elevated. This patient has prehypertension, defined as 120-139mmHg systolic or 80-89mmHg diastolic.

Type 1 diabetes is characterized by hyperglycemia secondary the body's inability to create insulin. Corticosteroids cause a rise in blood sugar even in a non-diabetic patient by increasing insulin resistance and triggering the liver to release additional glucose. Changes in sodium, albumin and potassium would not be expected findings in this scenario.