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8 Cards in this Set
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A 55 year old woman who experience menopause at age 50 undergo Central dual energy x-ray absorptiometry Tim a tree and has a t score greater than 2.5 the patient weighs 130 lb and has a BMI of 22. She sits at a computer all day at work. The NP caring for this patient should? |
Cancel the patient about diet and exercise. Women who are at least five years post menopausal or who have several risk factors should have bone density testing. Osteoporosis is defined as a t score of less than 2.5, and treatment is indicated for women with t scores that are two or more standard deviations below the normal pre-menopausal level. It is not necessary to initiate treatment at this time |
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A 50 year old white woman is experiencing menopause asks the NP what she can do to prevent osteoporosis. She has a negative family history and no risk factors. The NP should counsel her to? |
Take supplemental calcium and vitamin D everyday. Post-menopausal woman should consume 1200 mg of calcium and at least 1,000 units of vitamin D each day. Bi phosphonate therapy should be considered for persons with known risk factors bone density testing is indicated for women with risk factors and then routinely after age 65. Patients should be encouraged to engage in High Impact Sports if possible to improve bone density |
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A sixty-year-old woman with a central dual energy x-ray absorptiometry with a t score of 1.9. A health history reveals no risk factors for osteoporosis. The NP should |
Prescribed alendronate sodium. Fosamax. This Woman's t score is less than 2.5 and indicates osteoporosis. She should begin treatment with the Buy phosphonate. Increasing physical activity and taking supplemental calcium and vitamin D are indicated as well but not as part of a medication regimen. Calcium is not a first-line medication |
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A 70 year old patient who has a high fracture risk has been taking alendronate, Folsom Max, and calcium for 6 months. The NP orders a urine ntx level, which is 42. The NP should discontinue the alendronate and prescribe? |
Teriparatide, Forteo. Teriparatide is used in patients with a high fracture risk or in whom by phosphonate therapy has failed. Raloxifene and ibandronate are second line treatments for patients with usual fracture risks. Calcium is a last line treatment |
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A 60 year old female patient has begun taking a daily by phosphonate to prevent osteoporosis and complains of GI upset and dyspepsia. The NP is initial response should be to |
Review the instructions for taking the drug with the patient. Oral bi phosphonates must be taken on an empty stomach, and the patient must remain upright and not eat or drink anything for 30 to 60 Minutes. GI upset and dyspepsia are frequent and can be minimized with correct Administration. A PPI is not indicated. IV bi phosphonates may be indicated if the patient is unable to tolerate the oral drug after correct Administration is confirmed. Bi phosphonate should not be taken with food |
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A 50 year old woman with osteopenia will begin taking raloxifene, Avista. When counseling this patient about this drug regimen, the NP should tell her to |
Go for walks daily. Raloxifene is a selective estrogen receptor modulator, and it carries a risk of venous thromboembolism. Patients should be encouraged to avoid immobilization. The other instructions are part of medication teaching about biphosphonates. Which are take the medication 1 hour before meals, sit upright for 30 minutes after taking the drug, avoid using diuretics while taking this medication |
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A sixty-year-old woman is in the clinic for an annual well-woman examination. She has been taking alendronate, Fosamax, 10 mg daily for 4 years. Her last bone density test yielded a t score of 2. Her urine and TX today is 22. She walked daily. Her fracture risk is low. The primary NP should recommend that she? |
Take a one to two-year drug holiday. The American Association of clinical endocrinologists recommends patients have a drug holiday after 45 years of by phosphonate treatment if osteoporosis is mild and the fracture risk is low. The other options are all viable treatment regimens but are not appropriate in this case |
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A patient who has several risk factors for osteoporosis has a bone density test that indicates osteopenia. The primary care NP plans to prescribe a by phosphonate. Before initiating treatment the NP should |
Order serum calcium and vitamin D levels. Patients must have adequate nutrition, calcium and vitamin d. Hypocalcemia and vitamin D deficiency must be corrected before therapy is initiated. Upper GI x-ray is indicated only if the patient is symptomatic. Patients at risk for fracture should not take ppis. Calcium and Vitamin D supplements should be given with by phosphonate therapy however the first action is to evaluate current serum levels |
