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30 Cards in this Set

  • Front
  • Back
Musculoskeltal disorders include (5)?
metabolic bone diseases
(osteoporosis, Paget's)
bone tumors
bone lesions
bone deformities
bone syndromes
Define osteoporosis, the "silent disease"?
a metabolic disease in which bone demineralization results in decreased density and subsequent fractures
The most common bones fractured before osteoporosis is detected are (3)?
vertebral column
Causes of secondary osteoporosis (15)?
bone cancer
diabetes mellitus
growth hormone deficiency
rheumatoid arthritis
cushing's syndrome
chronic airway limitation
metabolic acidosis
Marfan syndrome
osteogenesis imperfecta
prolonged immobilization
Paget's disease
female hypogonadism
The chronic use of these drugs cause secondary osteoporosis?
drugs that induce
hypogonadism (decreased
levels of sex hormones)
ethanol (alcohol)
high levels of exogenous
thyroid hormone
Assessing risk factors for primary osteoporosis?
client's age older than 60yo...
family history osteoporosis..
white or Asian race
thin, lean body build
low lifetime calcium intake
estrogen deficiency
androgen deficiency
smoking history
high alcohol intake
lack of physical exercise or
prolonged immobility
GO OVER PAGES 1161, 1162, 1163, 1164, 1165
Plan of Care
Medical Dx: osteoporosis
Nursing Dx: Imbalanced
Nutrition Less Than Body
Related Factors: Inability
to ingest or digest food or
absorb nutrients due to
biologic, psychological, or
economic factors

0. What might be defining characteristics?
1. What might expected outcomes be?

2. What might be nursing

3. What are rationales?
0.Reported or evidence of lack of food...
Lack of information or misinformation...

1.Has muscle tone greater than or equal to 4+...
Has skin with warm undertones...
No verbal report or obser-
vation of altered eating

2. Determine, in collabora-
tion with the dietician as appropriate, the number of calories and type of nutrients needed to meet nutrition requirements...
Provide appropriate information about nutritional needs and how to meet them...
Teach client and family about nutritional supplements, as appropriate.

3. Individual client needs for nutrients and calories should be the basis of a sound dietary plan.
Clients need accurate and timely information to make informed decisions about nutritional needs and how to meet them.
Additional vitamins and minerals, calories, dietary fiber, or othr nutritional components may need to be added to the diet of a client who is unable to eat a nutritionally adequate diet.
Clients on diets low in fiber may need additional fluids and supplemental fiber to maintain bowel regularity.
Other drug names for calcium?
Usual dosage of calcium?
1-1.5 g in divided doses PO
When taking calcium, give a third of daily dose at _____.
Push fluids.
It's good to give some calcium at bedtime because?
it is most readily utilized by the body when the client is fasting and immobile.
What is it best to push fluids while taking calcium?
increased fluid intake aids in preventing the formation of calcium-based urinary stones.
Before giving calcium, assess for a history of urinary stones as calcium supplements are not given to clients who are?
susceptible to urinary stone formation.
When on calcium, it's important to monitor serum calcium level because?
hypercalcemia, or calcium excess, is a side effect of calcium supplementation.
When giving calcium, monitor urinary calcium level...level should be no more than?
4 mg/kg in 24 hrs...observe for signs of hypercalcemia
Hypercalcemia can result in?
urinary stones
cardiac dysrhythmmias
increase/decrease in skeletal
muscle tone
Other drug names for estrogen?
Usual dosage for estrogen is?
0.425-1.25 mg PO for 25 days/mo
When taking estrogen, assess for history of?
gallbladder disease
liver disease
thromboembolitic disease

(estrogen therapy is withheld from patients with
susceptibility to exacerbation of one or more of these problems
When taking estrogen, teach the importance of gynecologic exams every ____ ____.
6 months
Which cancers can result from estrogen therapy?
endometrial cancer
breast cancer
When taking estrogen, watch for vaginal bleeding because?
it's a side effect and a sign of possible endometrial cancer
What 2 circulatory conditions can be caused by taking estrogen-progesterone therapy?
hypertension...monitor blood pressure

thrombus formation

both of these conditions can cause elevated cholesterol

(monitor liver enzymes as well for liver involvement)
What is the best time to take and what is the best position to be in when taking Fosamax (Alendronate)?

Same applies for Ibandronate (Boniva)
take early in a.m. with 8 oz. of not lie down until after breakfast

uncommon, but esophagitis or esophageal ulcers may result
When is the best time to give Risedronate (Actonel) and what side effects are possible?
give about 30 minutes before a meal (preferably breakfast)...follow interventions for alendronate

observe for CNS side/adverse effects, such as drowsiness, anxiety, agitation...drug can cause CNS effects that may not be tolerated
Why should weight and blood pressure be monitored frequently while taking Raloxifene (Evista)?
drug causes increased water and sodium retention
Why should liver function tests be monitored while taking Raloxifen (Evista)?
can cause increased LFTs or worsen hepatic disease (should not be given to client who has liver disease)
When taking calcitonin intramuscularly, what is an important nursing intervention to prevent irriated and reddened sites?
rotate injection sites
What are common side effects of calcitonin?
Why is it important to monitor renal function, calcium, and vitamin D levels?
toxicity from calcitonin can cause renal problems