PREDISPOSING FACTOR PRECIPITATING FACTORS

- AGE: 80 yrs. Old - DIET: eating foods rich in sugar, carbs, and fats
- Family History of DIABETES - LIFESTYLE: smoking, drinking alcohol
- Hereditary - Compliance: no maintenance of meds. for DM

Exhaustion of beta cells occurs

Altered pancreatic insulin production

Decreased insulin production

Decreased absorption of glucose by the cells

Glucose is unable to enter the cells

Glucose remains in the blood stream

HYPERGLYCEMIA (304
Increased serum glucose level mg/dl, 13.2 mg/dl)

Sluggish flow of Serum osmolarity Tissue perfusion Osmotic Glucose Glucose intake
blood pressure in concentration of cells
of kidney blood in urine
Blood viscosity
Impaired delivery ATP
of blood Impaired Failure to H20 from cell Reabsorption production
components Blood flow to the removal of initiate towards the of glucose in
organs and extremities waste erythropoietin blood renal tubule Energy for
normal cells
Inadequate
Tissue perfusion in functions
inflammatory Impaired Stimulation of Dehydration Osmotic
response nerves
removal of the bone pressure Cells
waste from marrow fails starvation
Nerve hypoxia Stimulation of
Microorganism blood H20 occurs
osmoreceptors
would enter the reabsorption
Segmental RBC
body at any route Stimulation of
demyelization Glucose level production thirst the hunger
exceeds renal decreased Urine output
mechanism
threshold
Infection occurs Nerve damaged POLYDIPSIA
RBC POLYURIA Hunger occurs
Impaired renal (4.5)
WBC (14.4), Excessive glucose is
Fnx
eusinophils converted into SORBITOL POLYPHAGIA
(7%) w/c accumulate in nerves Fatigue
Permeability
of the renal
Inadequate Sorbitol impairs
cell wall
nutritional motor nerve
support conduction
Filtration of
macro cells &
Poor Paresthesia, particles
wound numbness
healing

Sugar+2,
protein+2,
Decreased blood+5, RBC
PR (60 bpm) >100/hpf

DIABETES MELLITUS
Pathophysiology of BPH
Thickening of the cardiac blood vessels
wall

Plaque formation begins

Occlusion of the blood vessels occurs

Blockage of blood flow

Myocardial ischemia occurs + TROPONIN T

Half of the bundle of his
ST-T loss its function
abnormality
Decreased myocardial O2 supply
Left fascicular block occurs

Increased cellular hypoxia

Mild left
axis
Increased lactic acid production release CHEST PAIN deviation
of metabolites

Altered cell membrane functions

MYOCARDIAL INFARCTION
(ACS)

Ineffective Reduced right Decreased Backflow of Shifting of

Grade 2
right ventricular cardiac blood into the fluids into edema @
ventricular pumping output right atrium and interstitial lower
extremities
contractility ability peripheral spaces
circulation

SINUS DOB,
BRADYCARDIA fatigue, with
rales upon
auscultation

Ineffective Reduced left Decreased Backflow of

left ventricular cardiac blood into the Pulmonary Pulmonary
ventricular pumping output left atrium and congestion edema
contractility ability lungs

HEART FAILURE
PREDISPOSING FACTORS PRECIPITATING FACTORS
- AGE: 80 yrs. Old - SMOKING
- FAMILY HISTORY OF BPH - WITH DM, HF, AND MI
- NORMAL BODY CHANGES

As mans age increased Deterioration of the blood vessel in the

prostate gland increased prostate

Androgen Blood flow becomes abnormal and 02

supply impaired

Testosterone

Dihydrosterone

Binds to nuclear
androgen receptors

Signals growth factors Stimulation of cell growth

HYPERPLASIA

Encroaches upon the

Increased size of prostate Overwhelms the detrusor
bladder neck occurs
muscles ability to ensure
effective bladder
evacuation by micturition
Reduced ability to funnel
in response to micturition

UTI (1-2 PUS

CELLS), Obstruction occurs Increase urethral
HEMATURIA
resistance

LUTS

Feeling of
Dribbling of Increased daytime URGENCY NOCTURIA
incomplete
urine voiding frequency
emptying of
the bladder

POLYURIA

BENIGN PROSTATIC HYPERPLASIA