BIOM30001 Lecture Notes - Lecture 12: Behaviour Therapy, Arcuate Nucleus, Amylin

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plumdeer622

3 Nov 2018

School

University of Melbourne

Department

Biomedicine

Course

BIOM30001

Professor

All

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Document Summary

Long term effects of weight loss physical activity. Long term effects of weight loss behavior therapy. Most people regain weight after all these weight loss therapies. Arcuate nucleus within hypothalamus has 2 nerves that primarily regulate food intake. Neuropeptide y nerves that produce npy and agrp. Pom c nerves that produce cart and nmsh. Hormones from stomach, gut, pancreas and fat regulate these nerves. Ghrelin is the only hormone that makes you hungry. This tells us the null position of the hypothalamus is to look for food. We only stop looking for food if we have a lot of these factors to tell us to stop. Leptin normally acts as a negative feedback to becoming obese. Soon after weight loss, cck and leptin drop but ghrelin increases. Itt treats those who drop out of study by assuming they regain all weight. After losing weight, fat cells stop making leptin. Leptin only comes up if weight is regained.

Related Questions

Behavior Topic : Increasing physical activity

1) the behavior you wish to change â: Increasing physical activity

âHow does it affect your life?

2) Establish some Baseline data about your behavior increasing physical activity

You wonât know where you are if you donât know where you started

i.e. how do you know if you lost weight, if you donât know how much you weighed?

âKeep a diary of your habits for a few days

âWrite down your feelings on those days, especially in relation to the activity you want to change

âWhat triggers do you notice in relation to your behavior?

âWhat do we know about your behavior? What contributes to it?

âWhat is the history of this behavior? When it is worse? Better?

2b) Summarize your baseline data. ââ

Identify any patterns you see.

Look at the positives and the negatives

Accept what you have found as accurate

Focus on strengths as well as weaknesses

Identify any patterns you see. If they are strengths, use them as such, if the patterns are behavior weaknesses, work on changing them.

3) Establish some specific goals. â

Short term goals

Long term goals

Every journey starts with the first step, remember that.

If long term goal is to lose 30 pounds, short term should be one pound per week. You canât do it all in a day! And you will get sad if you donât see immediate results. Even if you are choosing to quit smoking cold turkey, you need to see the accomplishments of making it one day, then a weekâ¦..

What is a short term goal? This is a smaller project related to your overall goal of being a healthier, happier you!

âe.g. lose 8 pounds over the quarter

What is a long term goal? This looks at overall, lasting improved health for your lifetime, e.g.

âEat more fruits and veggies EVERY day

âMeet your calcium intake requirement EVERY day

4) Make a personal contract to accomplish your goals. â10 points

Write down both the starting and ending dates. This will help you focus on specific activities for reaching your goals....

Specify the time

Specify the personal resources

Specify the energy that you will need to commit to this project

Based on âMorgan: A case of Diabetesâ by Lisa Rubin and Clyde Freeman Herreid (National Center for Case Study Teaching in Science)

The Patient:

Morgan Water is a 27-year old Native American that lives on a reservation in Oklahoma. Nearly Â¼ of Morganâs tribe has diabetes but she has no direct family history of diabetes, heart disease, or other serious conditions. She is however obese (BMI = 32) and leads a sedentary lifestyle. Morgan has been suffering from an increasing persistence of symptoms including unusual thirst, dizziness, blurred vision, and numbness in her right foot. The symptoms have been developing over several months but as she is planning her wedding she attributed them to nerves. She is finally persuaded to see her family doctor. Her non-fasting blood glucose level was elevated so the doctor has her return the next morning for a fasting blood sample so they could more accurately measure her blood glucose and insulin. Her blood results are below:

Test	Morganâs values	Normal range	Pre-Diabetic range	Diabetic range
Plasma glucose, mg/dl	260	70 -139	140 - 199	â¥ 200
Fasting glucose, mg/dl	140	â¤ 99	100 - 125	â¥ 126
A1C, %	7.6	~ 5	5.7 â 6.4	â¥ 6.5
Fasting Insulin, mIU/ml	34	2 - 10	10 - 20	â¥ 20

The recommendation of Morganâs doctor was to improve her exercise, good nutrition, and weight loss. He recommends meeting with a nutritionist to assist Morgan in her weight loss goals. When Morgan got home and told her family the diagnosis they however had LOTS of suggestions on how she can lose weight. Below is a description of the advice given to her by three family members.

Best friend Savannah:

âYou know how Iâve been losing weight? Well, Iâve been on the Atkinsâ Diet. I heard about it on TV. Itâs great! You get to eat steak, chicken wings, and all the good stuff. All you have to do is limit carbohydrate intake. You should definitely give it a try. This diet has been around for years and it has worked for lots of people, including me.â

*Note: Atkinâs Diet recommends: 10% carbohydrates, 55% fats, 35% protein

Brother Alan:

âI think the best thing for you to do is exercise and stop eating all of that pizza and candy and food filled with fat. Our people never used to eat that junk. I say eat meals that are nutritionally balanced and high in fiber and low in refined sugars and saturated fats. And run a lot. Stop sitting around the house.â

Grandfather:

âMorgan, it is true that it is best to live in harmony and balance â to eat a nutritionally balanced diet that includes carbohydrates, proteins, and âgoodâ fats to meet your bodyâs needs. That is good. But look to your heritage. Our people were never overweight before we started eating âcivilizedâ food. Look to our native diet. I think you should look to traditional herbal remedies for help. What Alan says is true. Exercise is good. But it is sometimes not enough. Our people have always looked to natural medicine for cures. They will lift your spirits and energize you. Then you will lose weight and you will be healthy again. I hear the herbs from the diet shop are safe and good. But you must take them like the medicine label says. It canât hurt to try them.â

*Note: these herbal supplements Morganâs grandfather is recommending contain the herb

ephedra (ephedrine).

Question 5:

Given Morganâs metabolic state, what is the primary fuel source for her cells currently?

A. Carbohydrates (glucose)

B. Fats

C. Proteins

D. It is a balance of all three

Question 6:

Metabolic ketoacidosis is a common problem with diabetics, which is caused by which of the following?

A. Excessive oxidation of fatty acids, leading to an accumulation of ketone bodies in the blood.

B. Excessive oxidation of glucose, leading to an accumulation of ketone bodies in the blood.

C. Excessive oxidation of proteins, leading to an accumulation of ammonia in the blood.

D. Hyperglycemia.

Question 7:

Which weight loss suggestion is designed to achieve some level of ketosis?

A. Atkins Diet

B. Exercise

C. High fiber diet

D. Herbal treatments

Question 8:

One major side effect of the herbal supplement can be hot flashes and increased perspiration due to increased thermogenesis, what is the likely cause of the heat production?

A. Increasing the activity of phosphfructokinase-1.

B. Increasing the activity of the pyruvate dehydrogenase complex.

C. Increasing the activity of citrate synthase.

D. Increasing the activity of uncoupling proteins.

Question 9:

Would substituting fiber and complex carbohydrates (larger % cellulose) for the simple sugars and starches (high sucrose and amylose/amylopectin) help Morgan lose weight, why?

A. Yes, because complex carbohydrates like cellulose are largely indigestible so they pass through

the digestive tract without being absorbed.

B. Yes, cellulose contains less glucose residues than amylose or amylopectin.

C. Yes, because the fructose in sucrose is much more responsible for weight gain than the glucose.

D. No, because cellulose, amylose, and amylopectin are all composed of glucose so it doesnât

matter.

Question 10:

Which weight loss suggestion will lead to an increased need for gluconeogenesis?

A. Atkins Diet

B. Exercise

C. High fiber diet

D. Herbal treatments

PLEASE ANSWER ALL THESE QUESTIONS I REALLY NEED THEM.

25. What is the most important discussion of the interdisciplinary team at regularly scheduled meetings.

A. Care access issues

B. Standard dized testing resulting

C. Risk reduction assessment

D. Complaince issues

26. What should be the nurse's primary consideration while allowing for patient autonomy and reducing risk when dealing with end of life care ?

A.stage of illness

B. Cognitive impairment

C. Weight

D. Age

27. Whicn statement from a nurse would indicate good judgment when considering common myths regarding physical restraint use ?

A. Alternatively to physical restraints are unavailable

B. Inadequate staffing causes the need for physical restraint use.

C. Failure to restrain puts individuals at risk for legal liability

D. Risk of falls exists when restraints are used.

28. A 66 year- old patient lives alone and has a BMI of 32, as well as diabetes. As the nurse begins to encourage the patient to increase current levels of physical activity, the nurse should recognize common barriers identified by the elderly. Which barrier to physical activity is least common for the elderly?

A. Finding safe area to walk

B. Swelling of ankles

C. Having pain from arthritis

D. Experience fatigue

29. An 81-year-old patient is a new resident in Hill Side Nursing Home. Upon admission the patient had a Braden score of 17. Which statement would indicate that the RN on duty lacks understanding that the patient is at risk for pressure ulcers?

A. The primary risk factor is immobility.

B. The primary risk factor is a BMI < 24

C. The primary risk factor is polypharmacy

D. The primary risk factor is malnutrition

30. Harriett is a 92-year-old who lives in assisted living; she recently fell and broke her hip. Harriet and her family would like to keep Harriet safe and at the highest level of independence on her return to her accommodations from the hospital. Which action should the nurse take to help Harriet and her family ?

A. Counsel about home safely assessments

B. Tell Harriet to become active in the local Tai Chi program

C. Discuss the rate of unintentional injuries for older aldults

D. Have Harriet and her family request a daily room check by staff

31. Sharron is a 90- year-old female who lived in Asia for most of her life and is a nonnative English speaker. She recently had emergency gallbladder surgery. Which nursing action would be best to do before discharging Sharron back to her accommodations?

A. Explore her use of alternative medicines

B. Explore English as a second language lessons

C. Explore aromatherapy for relaxation purposes

D. Explore counciling for depression options.

32. Agnes is a 77 year old who lost her husband last year and has congestive heart failure. She has a move in with her son Alex. She has been brought to the ER by Alex who says she is short of breath. He doesn't know how long she has been in the state, nor does he know the medication she should be on. What is the nursing priority?

A. Admit and stabilize the patient

B. Call Agne's daughter

C. Contact social services

D. Ask the son if he is overwhelmed

33. Duke is a 90 year old male with Alzheimer's Dementia living in a nursing home. Recently he has been experiencing sun downing. Which solutions should the nurse consider?

A. Restraining the patient in a chair in lobby area where he can see people.

B. Putting the patient in a room by himself with low light and a closed door

C. Giving the patient nonpharmacologic treatments such as putting the patient in a well lit room

D. Giving the patient Alprazolam to calm him down.

34. Ruth is a 75 year old residing in an assisted living facility and is at risk for fluid volume deficit. Which nursing action would ensure the most accurate monitoring of Ruth's fluid status in a co-created plan of care? Choose 2 answer

A. Measure and record fluid intake and output.

B. Check for crackles in the lungs every shift

C. Ask Ruth to weight each day at the same time

D. Take the vital signs assessed every 4 hours.

35. Which activity would be helpful for older adult to engage in to prevent or interrupt the course of frailty?

A. maintaining social relationships

B. Taking a medication for each chronic disease/ disorder

C. Avoiding travel D. Sleeping greater than 10 hours daily.

Q36 What

should the nurse first instruct the older adult to do when the older adult is beginning an exercise program

A Purchase new gym shoes

B work out until you sweat

C Purchase membership at nearby gym D proceed with low intensity and moderat

BIOM30001 Lecture Notes - Lecture 12: Behaviour Therapy, Arcuate Nucleus, Amylin

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