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30 Cards in this Set
- Front
- Back
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Musculoskeltal disorders include (5)?
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metabolic bone diseases
(osteoporosis, Paget's) bone tumors bone lesions bone deformities bone syndromes |
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Define osteoporosis, the "silent disease"?
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a metabolic disease in which bone demineralization results in decreased density and subsequent fractures
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The most common bones fractured before osteoporosis is detected are (3)?
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wrist
hip vertebral column |
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Causes of secondary osteoporosis (15)?
(BaDGeR CHOMP Food CH MP C |
bone cancer
diabetes mellitus growth hormone deficiency rheumatoid arthritis cirrhosis cushing's syndrome chronic airway limitation hyperparathyroidism hyperthyroidism metabolic acidosis Marfan syndrome osteogenesis imperfecta prolonged immobilization Paget's disease female hypogonadism |
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The chronic use of these drugs cause secondary osteoporosis?
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anticonvulsants
corticosteroids drugs that induce hypogonadism (decreased levels of sex hormones) ethanol (alcohol) heparin high levels of exogenous thyroid hormone |
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Assessing risk factors for primary osteoporosis?
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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 |
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GO OVER PAGES 1161, 1162, 1163, 1164, 1165
Plan of Care Medical Dx: osteoporosis Nursing Dx: Imbalanced Nutrition Less Than Body Requirements 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 interventions? 3. What are rationales? |
0.Reported or evidence of lack of food...
Misconceptions... 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 habits... 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. |
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Other drug names for calcium?
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Os-Cal
Turns Caltrate-600 Citracal |
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Usual dosage of calcium?
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1-1.5 g in divided doses PO
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When taking calcium, give a third of daily dose at _____.
Push fluids. |
bedtime
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It's good to give some calcium at bedtime because?
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it is most readily utilized by the body when the client is fasting and immobile.
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What is it best to push fluids while taking calcium?
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increased fluid intake aids in preventing the formation of calcium-based urinary stones.
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Before giving calcium, assess for a history of urinary stones as calcium supplements are not given to clients who are?
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susceptible to urinary stone formation.
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When on calcium, it's important to monitor serum calcium level because?
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hypercalcemia, or calcium excess, is a side effect of calcium supplementation.
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When giving calcium, monitor urinary calcium level...level should be no more than?
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4 mg/kg in 24 hrs...observe for signs of hypercalcemia
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Hypercalcemia can result in?
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urinary stones
cardiac dysrhythmmias increase/decrease in skeletal muscle tone |
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Other drug names for estrogen?
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estrogen/progesterone
Premarin Prempro |
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Usual dosage for estrogen is?
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0.425-1.25 mg PO for 25 days/mo
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When taking estrogen, assess for history of?
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gallbladder disease
hypertension liver disease thromboembolitic disease tumors (estrogen therapy is withheld from patients with susceptibility to exacerbation of one or more of these problems |
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When taking estrogen, teach the importance of gynecologic exams every ____ ____.
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6 months
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Which cancers can result from estrogen therapy?
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endometrial cancer
breast cancer |
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When taking estrogen, watch for vaginal bleeding because?
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it's a side effect and a sign of possible endometrial cancer
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What 2 circulatory conditions can be caused by taking estrogen-progesterone therapy?
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hypertension...monitor blood pressure
thrombus formation both of these conditions can cause elevated cholesterol (monitor liver enzymes as well for liver involvement) |
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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 water...do not lie down until after breakfast
uncommon, but esophagitis or esophageal ulcers may result |
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When is the best time to give Risedronate (Actonel) and what side effects are possible?
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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 |
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Why should weight and blood pressure be monitored frequently while taking Raloxifene (Evista)?
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drug causes increased water and sodium retention
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Why should liver function tests be monitored while taking Raloxifen (Evista)?
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can cause increased LFTs or worsen hepatic disease (should not be given to client who has liver disease)
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When taking calcitonin intramuscularly, what is an important nursing intervention to prevent irriated and reddened sites?
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rotate injection sites
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What are common side effects of calcitonin?
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flushing
headache nausea vomiting |
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Why is it important to monitor renal function, calcium, and vitamin D levels?
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toxicity from calcitonin can cause renal problems
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