Patient Centered Collaborative Care Assessment Manifestations are related to

Patient centered collaborative care assessment

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Patient-Centered Collaborative Care Assessment Manifestations are related to excessive PTH or effects of hypercalcemia (excessive calcium) High levels of PTH cause renal calculi and deposits of calcium in the soft tissue of the kidney Bone lesions are due to an increased rate of bone destruction, resulting in pathologic fractures, bone cysts, and osteoporosis Anorexia, n/v, epigastric pain, constipation, weight loss are common Serum PTH, calcium, and phosphate levels and urine cyclic adenosine monophophate (cAMP) most common lab tests to detect hyperparathyroidism X-rays show kidney stones, calcium deposits, and bone lesions Arteriography, lCT scans, venous sampling of thyroid for blood PTH levels , & ultrasonography (US). Hyperparathyroidism: Nonsurgical Management Diuretic and hydration therapies – used for reducing serum calcium levels Monitoring cardiac function and I&O every 2 to 4 hours during hydration therapy.
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Monitor ECG tracings, for changes in T waves, QT interval & rate and rhythm. Monitor for hypocalcemia Preventing injury – high risk for pathological fractures Drug therapy – used when hydration & furosemide cannot reduce hypercalcemia Hyperparathyroidism: Surgical Management Parathyroidectomy, looking at respiratory distress, emergency trecestomy Postoperative care includes: Observe for respiratory distress. Keep emergency equipment at bedside. Hypocalcemic crisis can occur. Recurrent laryngeal nerve damage can occur Hypoparathyroidism Decreased function of parathyroid gland Iatrogenic – caused by removal of all parathyroid tissue during total thyroidectomy or deliberate surgical removal Idiopathic – can occur spontaneously, cause is unknown Hypomagnesemia – may cause hypoparathyroidism Interventions—correcting hypocalcemia, vitamin D deficiency, hypomagnesemia Chapter # 67 Care of Patients with Diabetes Mellitus Insulin Physiology Normal Insulin Secretion Types of Diabetes Type 1 Type 2 Gestational (GDM) Other specific conditions resulting in hyperglycemia Absence of Insulin Hyperglycemia
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Polyuria Polydipsia Polyphagia Ketone bodies Hemoconcentration, hypovolemia, hyperviscosity, hypoperfusion, and hypoxia Acidosis, Kussmaul respiration Hypokalemia, hyperkalemia, or normal serum potassium levels Acute Complications of Diabetes Diabetic ketoacidosis Hyperglycemic-hyperosmolar state (HHS) Hypoglycemia from too much insulin or too little glucose Chronic Complications of Diabetes Macrovascular/microvascular disease Retinopathy (vision problems) Nephropathy (kidney dysfunction) Neuropathy (nerve dysfunction) Macrovascular Complications Cardiovascular disease Cerebrovascular disease Microvascular Complications Eye and vision complications Diabetic neuropathy Diabetic nephropathy Male erectile dysfunction Metabolic Syndrome Also called syndrome X
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  • Spring '11
  • Nursing, Cortisol, blood glucose, blood glucose levels, Blood sugar

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