NCM 201 MIDTERM

• Mental status


  How a patient responds to a particular question/s of a healthcare worker
• Physical assessments


  Observe body built, height and weight in relation to the client's age, lifestyle and health
• Height should be proportionate to arm span. If not, consider Marfan's syndrome
• Syndrome


  Collection of signs and symptoms
• Marfan syndrome


  • Hereditary disorder that affects the body's connective tissues, long limbs in proportion to the trunk of the patient
  • Eye problems, long arm and fingers
• Marfan syndrome: signs and symptoms

  • Disproportionately long legs
  • Extreme tall and slender build
  • Long, narrow face
  • High arched neck and crowded teeth
  • Indented or protruding sternum
  • Dislocated lenses of the eyes
  • High pressure in the eye
  • Cystic changes in the lungs
  • Flexible joints
  • Flat feet
  • Curved spine
  • Abnormal heart sounds
• Turner's syndrome


  • Chromosomal anomaly in female births, missing an X chromosome on the 23rd pair
• Turner's syndrome: signs and symptoms

  • Short stature
  • Characteristic facial features
  • Low hairline
  • Fold of skin
  • Constriction of aorta
  • Shield-shaped thorax
  • Poor breast development
  • Widely spaced nipples
  • Elbow deformity
  • Shortened metacarpal IV
  • Rudimentary ovaries, Gonadal streak (underdeveloped gonadal structures)
  • Brown spots
  • No menstruations
• Gigantism


  Increase activity of anterior pituitary gland, problem in the growth hormone
• Marfan syndrome


  Disorder of connective tissues, has heart abnormalities (which means there is also a pulmonary problem), inherited gene defects in fibrilin
• Gigantism


  Enlarged soft tissue and late closure of the growth/epiphyseal plates (which means continuous growth)
• Epiphyseal line


  Closed, plate/stopped growing
• Dwarfism


  A person with short stature
• Causes of dwarfism


  • Gonadal dysgenesis (XO = Turner Syndrome)
  • Bone & Metabolic diseases
  • Idiopathic - no known cause or constitutional delayed growth
  • Abuse & neglect (independent of nutrition)
  • Genetic Mutations
• Achondroplasia


  Most common form of dwarfism, when growth plate chondrocytes inhibit from functioning & proliferating, early closure of the epiphyseal plate, stunts growth (but have average size of torso)
• Types of dwarfism


  • Proportionate - Same size all over
  • Disproportionate - May have some average-size parts
• Sthenic body type


  Average height, well-developed musculature, wide shoulders, flat abdomen, oval face, muscular, thick-set individual, broad chest, high diaphragm, stomach tends to lie transversely, gallbladder is high in the abdomen (away from midline), transverse colon is also high
• Hypersthenic body type


  Short, stocky, may be obese, broader chest, thicker abdominal wall, rectangular-shaped face, very muscular, thick-set individual, broad chest, high diaphragm, stomach tends to lie transversely, gallbladder is horizontal high in the abdomen (away from the midline)
• Asthenic body type


  Long, thin-chested lean individual, lower positioned organs (diaphragm, stomach, gallbladder, and transverse colon), stomach and transverse colon descended into pelvis (during erect position), exaggeration of the hyposthenic type
• Hyposthenic body type


  Tall, willowy, poorly developed musculature, long, flat chest, abdomen may sag, long neck, triangular face, similar to asthenic but features mentioned are not as marked
• Cachectic (cachexia)


  Profound and marked malnutrition, wasting, ill health
• Debilitated


  Weak, feeble, lack of strength, with weaknesses and loss of energy
• Kwashiorkor


  Patients that has a problem with their protein ingestion, protein ingested are not enough, malnutrition
• Marasmus


  Old man's face, aside from protein, lack of all nutrition
• Failure to thrive


  Physical and developmental delay or retardation in infants and children, seen in children with illness but more in those with psychosocial or maternal deprivation
• Maternal deprivation


  Lack of care from the mother, no breast feeding
• Endomorph


  Stocky build, with prominent abdomen
• Ectomorph


  Tall with long and lean limbs
• Mesomorph


  Husky and muscular body
• Assessing height and weight

  Compute for the BMI if ever patient is underweight, overweight or normal
• Body Mass Index (BMI)

  Ratio of your weight and height
• Weight in kilograms divided by height in meters squared
• Weight in pounds multiplied to 700, divide by height in inches, and divide again by height in inches
• People in categories above overweight are more prone to heart problems, pulmonary problems, coronary artery disease
• Waist circumference


  Male: 102cm (40 inches), Female: 88cm (35 inches), Abnormal: anything beyond the measurements

  
• Causes of obesity


  • Poor diet (high in fat and calories)
  • Sedentary lifestyle
  • Not enough sleep
  • Genetics (rate of metabolism)
  • Increasing age (decreases muscle mass, slows metabolic rate)
  • Pregnancy (post-pregnancy weight may be difficult to lose)
• Android (male) obesity


  Fats are located mainly on the waist, central type of obesity, increases risk for certain diseases (diabetes mellitus II, high cholesterol and triglycerides, hypertension, and heart disease)
• Gynecoid/Gynoid (female) obesity


  Fats are located on the hips and thighs, peripheral type of obesity
• Cushing syndrome


  Due to excess cortisol in the body (from medications or pituitary gland tumor), example of medication - PREDNISONE, truncal fat, moon face (bibilog ang mukha), thin limbs

  
• Causes of unexplained weight loss

  • Cancer
  • Diabetes mellitus (problem with insulin)
  • Hyperthyroidism
  • Depression
  • Diuresis
  • Kidney failure