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395 Cards in this Set
- Front
- Back
Bouchard's Nodes
|
raised bony growths over the proximal phangeal joint of the hand, less frequent than heberdean's nodes in osteoarthritis
|
|
Cancellous Bone
|
a spongy bone resulting from structural units fitting loosly together leaving many spaces between bone tissue.
|
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Compact bone
|
a dense structured bone resulting from structural units fitted closely together,
|
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Compartments Syndrome
|
occurs when circulation to a compartment is impeded due to excessive pressure against the non elastic fascia
|
|
What does Compartments syndrome result in?
|
tissue death and nerve injury
|
|
countertraction
|
a pulling force exerted in the opposite direction to prevent the client from sliding to the end of the bed
|
|
crepitation
|
a grading or popping sound caused bones rubbing together
|
|
degenerative joint disease
|
a slowly progressive disorder or articulating joints esp weight bearing, primarily affecting middle aged to older adults
|
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gout
|
a metabolic disorder char by elevated uric acid levels in the blood resulting in deposition of uric crystals in synovial fluid and joint tissues
|
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Heberden's nodes
|
raised bony growths over distal interphalangeal joints that occur freq. in osteoarthritis and are a common manifestation of the disease in women.
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Internal fixation
|
a surgical implanted fracture immobilization device to realign a fracture
|
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laminectomy
|
a surgical incision of the lamina, done to relieve symptoms related to intervertebral disk
|
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Osteomylitis
|
a acute or chronic infection of the bone usually caused by staph aureus organism
|
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osteoporosis
|
disease char by low bone mass and deteroration of bone tissue causing the bone to become fragile and susceptible to fractures
|
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sprain
|
a stretch and/or tear of a ligament
|
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strain
|
a stretch or tear of muscle fibers
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traction
|
direct pulling force applied to a fractured extremity that results in realignment of bone
|
|
what are the two classifications of bones?
|
compact (dense) cancellous (spongy)
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Why is a fracture worse than a tear?
|
fracture takes longer to heal, reduction in calcium, RBC production
|
|
a decreased H and H means?
|
RBC prod down, O2 to RBC's down, # RBC's down
|
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What is the most common test of musculoskeletal problems?
|
X Ray
|
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Post arthroscopy nsg implications
|
take pain meds, limit activity, look for hemotoma or bleeding, NV assessment, temp color cap refill sensation, teach S/S of infect
|
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Arthrogram
|
contrast media injection, series of pics taken while ct. moves joint
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Pre op edu for arthrogram
|
feeling of warmth, nausea, H/A, itching, hives, rash, salty tast
|
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post op edu arthrogram
|
temp discolor of skin and urine normal , ck NV status of site
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CT Scan
|
combines Xrays with comp. tech to get cross section of structures of body
|
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ct edu for CT scan
|
if dye is used, increase fluid intake, monitor evac of contrast media, white stools normal,
|
|
Bone scan
|
tech used to create images of bones on a comp screen or film using a sm amt of radioactive material traveling through blood stream
|
|
What in a bone scan details blood flow to a bone
|
the amount of dye absorption
|
|
What are the 4 types of bones?
|
long, short, flat, irregular
|
|
What type of tissue is bone?
|
connective
|
|
What is responsible for laying down new bone?
|
osteoblasts
|
|
What are the 5 functions of bone?
|
support, protection, movement, hematopoiesis, mineral homeostasis
|
|
In what way do bones provide support?
|
provide skeletal framework, and give form and shape of body
|
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How do bones provide protection?
|
protect body organs
|
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How do bones provide movement?
|
muscular attachments to one and by joint movement
|
|
What is hematopoiesis?
|
formulation of RBC's
|
|
Where are RBC's formed
|
bone marrow
|
|
If the RBC's are being formed outside of the marrow what is this a sign of?
|
disease
|
|
how do bones provide mineral homeostasis
|
bones store CA, phosphate, carbonate, magnesium
|
|
what is remodeling?
|
process by whcich existing bone is resorbed and new bone replaces the old
|
|
Where is 99 percent of the bodies calcium found?
|
bone
|
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What is necessary for bone formation
|
calcium
|
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What has an inverse relationship with calcium?
|
phosphorus
|
|
What controls calcium and phosphorus
|
PTH
|
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What results in the release of phosphorus?
|
bone resorption
|
|
What inhibits bone resorption
|
calcitonin
|
|
What vitamin elevates calcium and phosphorus?
|
vitamin D
|
|
Where is Growth hormone secreted?
|
anterior lobe of pituitary gland
|
|
What is a manifestation of decreased levels of GH?
|
dwarfism
|
|
What is a manifestation of increased levels of GH?
|
acromegaly
|
|
what regulates the metabolism of proteins
|
glucocorticoids
|
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What stimulates osteoblast activity and inhibits PTH?
|
estrogen
|
|
What happens if a bone is not stressed?
|
bone resorption
|
|
what are the three types of muscle?
|
visceral, cardiac, skeletal
|
|
what is each skeletal muscle covered in?
|
fascia
|
|
tonic contraction
|
continual partial contraction that is vital in the maintenance of posture
|
|
Isotonic contraction
|
tension within the muscle is constant but the length of muscle changes
|
|
Isometric contraction
|
tension within the muscle increases, but muscle does not shorten
|
|
a twitch contraction
|
jerky reaction to a single stimulus
|
|
tetanic contraction
|
more sustained contraction than the twitch produced bhy a series of stimuli in rapid succession
|
|
spasm contraction
|
involuntary contraction caused by stimulation of an entire motor unit
|
|
treppe contraction
|
stronger twitch contractions in response to regularly repeated
|
|
Fibrillation contraction
|
a synchronous contraction of individual fibers
|
|
convulsive contractions
|
abnormal uncoordinated tetanic contractions cocurring in varying groups of muscles
|
|
what sets off the contraction of a muscle?
|
acetylcholine
|
|
What is the most common type of cartilate
|
hyaline
|
|
what is cartilage?
|
composed of fibers embedded in a firm gel, strong but flexible
|
|
What are ligaments?
|
parallel angds of flexible, dense fibrous connective tissue
|
|
What is the primary function of ligaments
|
connect the ends of bones and provide stability
|
|
Ligaments and movements
|
ligaments permit movement in some directions but limit it in others
|
|
What are tendons?
|
bands of dense fibrous tissue that ofrm the origin of muscle to bone
|
|
What is bursae?
|
small sacs of connective tissue located wherver pressure is exerted over moving parts.
|
|
what are joints
|
places where bones come together and allow movement
|
|
What happens with cartilege when you age?
|
it becomes more rigid
|
|
How much bone mass has a women usually lost by age 70
|
50
|
|
when does muscle strength reach its peak
|
25 to 30 years
|
|
what is sarcopenia
|
age-related skeletal muscle loss
|
|
How does bone change with aging?
|
decreased total bone mass, impaired osteoblastic activity, resorption exceeds growth, erosion of haversian systems, corticol bone changes to cancellous bone
|
|
What are potential problems with bones and aging?
|
osteoporosis, pathologic fracture, delayed healing
|
|
Changes in muscles with aging?
|
decline in strength past 70 years, decline in # of muscle fibers, decrease in muscle mass, atrophy of muscle cells
|
|
What are some potential problems with muscles and aging
|
weakness, uncoordination, disuse atrophy, slow unsteady gait, poor posture, falls, contractures
|
|
Changes with joints and aging
|
decreased elasticity of cartilage, increased susceptibility to tears in cartilage
|
|
potential problems with joints and aging
|
arthritis, decreased range of motion, contractures
|
|
What races are at a greater risk for osteoporosis?
|
asians, caucasians
|
|
what is posture indicative of?
|
char of specific prob like scoliosis, kyphosis
|
|
What does being overweight possible indicate
|
diminished ability to perform reg. exercise or activity, excess weight causes increased stress on joints
|
|
Underweight risk factors
|
inability to make nutricious meals, may relate to anorexia, N/V or malabsorption of food
|
|
a malnourished female is at risk for?
|
osteoporosis
|
|
What happens to skin with aging?
|
down turgor, thinner skin,
|
|
What are individuals with limited mobility subject too?
|
skin breakdown, pressure ulcers, watch for shearing forces
|
|
what does warmth over a joint possible indicate
|
inflammation or infection in a joint
|
|
What does a bony enlargment in a joint show?
|
disease process
|
|
What are subcutaneous nodules indictative of?
|
rheumatoid arthritis,
|
|
What are tophaceous deposits indictative of?
|
Gout
|
|
what is a swan neck deformity?
|
flexion and hyperextension of joints in hand
|
|
In what disease is a swan neck deformity found?
|
rheumatoid arthritis
|
|
What is a ulnar deviation
|
fingers deviate at the metacarpophalangeal joints toward ulnar aspect of hand
|
|
What is a valgus deformities
|
distal arm of the angle of the joint points away from the midline of the body
|
|
hallux valgus
|
great toe turn towards other toes
|
|
genu valgum
|
knock knees
|
|
talipes valgus
|
eversion of the foot
|
|
genu varum
|
bowing of knees
|
|
talipes varus
|
inversion of foot
|
|
scoliosis
|
lateral curvature of spine
|
|
kyphosis
|
throacic spinal curvature, posterior
|
|
atorphy
|
reduction in size of extremity or body part
|
|
hypertrophy
|
abnormal enlargement of an organ or body part
|
|
pes planus
|
flat feet
|
|
pes cavus
|
high instep
|
|
range of motion
|
normal arc of movement provided for by the structure of a joint
|
|
What ROM is performed independently?
|
active
|
|
What ROM is performed with the assistance of someone else
|
passive
|
|
scoliosis screening
|
forward bend test to observe symmetry and height of scapulae, shoulders, iliac crests, rib cage
|
|
what is a myelography
|
radiologic examination of the spinal canal
|
|
What is elevated in serum muscle enzymes
|
muscle diseases
|
|
What levels are most commonly used to diagnose and monitor treatmetn of muscular dystrophy
|
Aldolase
|
|
What should be avoided when aldolase is being monitored
|
IM injections
|
|
What are enzyme levels an index of?
|
both the progress of myopathic disorders and effectiveness of treatment
|
|
normal values of AST
|
8-20 U/L
|
|
normal aldolase values
|
3-8.2 U/dl
|
|
CPK-MM normal value
|
90 to 97%
|
|
What does the FTA-ABS exclude
|
presence of syphalis
|
|
what is the rheumatoid factor?
|
found in individuals with rheumatoid artritis
|
|
What is the level of RA to be considered positive
|
titrations of 1:40 or more
|
|
ESR
|
erythrocypte sedimentation rate
|
|
ESR indicates what?
|
increased rate of settling of erythrocypes is an important index or presence of inflammation
|
|
Serum complement
|
low levels show rheumatoid arthritis
|
|
Normal vales of ESR?
|
< 15mm/hr men and < 20 mm/hr female
|
|
What are symptoms of anemia?
|
extreme tiredness, fatigue, weakness,
|
|
normal hematocrit levels
|
45-50 men, 40 - 45 female
|
|
normal values of calcium
|
total 9 - 10.5
|
|
What is monitored in treatment for osteoporoisis
|
ALP
|
|
What does ALP stand for?
|
alkaline phosphatase
|
|
What with calcium plays a vital role in bone metabolism
|
phosphorus
|
|
normal phosphorus levels
|
2.5-4.5
|
|
What is used as nonspecific indicator of infection and inflammation
|
C reactive protein
|
|
24 hour urine test is used to determine
|
creatine creatinine ratio
|
|
with muscle disease the ability of muscle to convert creatine is
|
decreased
|
|
the amount of creatine excreted by kidneys is ? in muscle disease
|
increases
|
|
Urinary uric acid levels are helpful in ?
|
diagnosis and decisions regarding treatment modialities for gout
|
|
What is the normal value in urinary uric acid levels?
|
not exceeding 900 mg uric acid excretion a day
|
|
Dpd
|
Deoxypyridinoline
|
|
what type of biopsy is used on the skin?
|
punch biopsy
|
|
What type of procedure is a muscle biopsy
|
operative procedure
|
|
how does inadequate immobilization effect bone healing?
|
movement of fragments
|
|
how does poor approximation of fracture fragment impede bone healing
|
inaccurate reduction or malalignment of fracture fragments
|
|
How does a compromised blood supple impede bone healing?
|
damage to nutrient vessels, periosteal or muscular injury, severe comminution, avascularity
|
|
How does excessive edema at fracture site impede bone healing?
|
tissue swelling impedes supply of nutrients to area of fracture
|
|
how does bone necrosis impede bone healing
|
injury to blood vessels impedes supple of nutrients to involved bone
|
|
how does an infection at the fracture site impede bone healing
|
an infection disrupts normal clalus formation
|
|
how do metabolic disorders or diseases impede bone healing
|
retard osteogenesis
|
|
how does soft tissue injury impede bone healing
|
disruption of blood supply
|
|
how does medication use impede bone healing
|
steroids cause osteoporosis
|
|
what can long term use of heparin cause?
|
osteoporosis
|
|
What type of film can be used to document healing
|
XRay
|
|
1st step in treating a fx
|
maintinaing airway and assessing for signs of shock
|
|
2nd step in treating a fx
|
splint the fracture
|
|
why do you splint the fracture
|
to prevent movement that may cause further injury, also can decrease pain
|
|
What is the 3rd thing you do in tx of a fracture
|
preserve correct body alignment
|
|
What is the 4th things you do in tx of a fracture
|
elevate
|
|
what do you do after you elevate a fracture
|
apply cold packs
|
|
What does applying cold packs to a fracture do?
|
reduces hemorrhage, edema and pain
|
|
How long after a fracture are cold packs useful?
|
24 hours
|
|
What do you observe for after all other steps of treating a fx are completed?
|
color, sensation, circulation, movement and temp
|
|
What is the most common type of external fixation device
|
casts
|
|
What is the mechanism by which a steady pull is exerted on a part or parts of the body
|
traction
|
|
When is traction used?
|
reduce a fracture, maintain correct alignment of bone frag, immob. a limb, overcome muscle spasm, stretch adhesions, correct derformities
|
|
What is countertraction
|
a force that counteracts the pull of traction
|
|
What is generally the thing that provides countertraction
|
the body
|
|
What type of traction uses the body as countertraction
|
Bucks
|
|
What is suspension?
|
use equip to suspend not pull on a body part
|
|
What are the two types of traction?
|
skin and skeletal
|
|
What are the two most common types of skin traction?
|
bucks and russells
|
|
What is traction applied directly to the bone
|
skeletal traction
|
|
What is used in conjuction with skin or skeletal traction to give the pt more movement
|
balanced supension
|
|
In traction, should ropes be straight and run straight through pulleys?
|
yes
|
|
What do you do when you are adjustion traction for a pt.
|
remove the weights
|
|
when a person is in traction, should you encourage them to change positions as much as possible
|
yes
|
|
What are the guidelines for positionng a pt with a fx?
|
maintain align, maintin direction of pull of traction, integrity of cast, positioning,
|
|
What are guidelines for pt in a cast?
|
see page 148
|
|
what is leading cuase of nonunion and delayed nion
|
infection
|
|
What is the primary symptom of infection
|
pain
|
|
What is pseudoarthrosis
|
impaired fx healing
|
|
CRPS
|
complex regional pain syndrom
|
|
what are fracture blisters
|
skin bullae and blisters representing areas of epidermal necrosis with separaion of the stratified squamous cell layer by edema fluid
|
|
Can fracture blisters be caused by compartmetn syndrome
|
yes
|
|
FES
|
fat embolism syndrom
|
|
when is FES most common
|
fractures of the pelvis, femur and tibia
|
|
what are some symptoms of FES
|
hypoxemia, tachypena, tachycardia, petechiae, fever, lipuria, chest pain, etc
|
|
pathophysiology of FES
|
fat globules released from marrow following fracures enter the bloodstream and obstruct pulmonary circulation
|
|
Pato of PE
|
DVT dislodges and obstructs pulmonary circulation
|
|
When does a FES usually occur?
|
1-4 days after injury
|
|
when does a PE usually occur?
|
4-10 days after trauma of devel of thrombophlebitis
|
|
What are some symptoms of a PE?
|
dyspnea, chest pain, apprehension, anxiety, cough, hemoptysis, fever
|
|
What are some risk factors of FES?
|
hypovolemia, shock, delayed immobilization of fracture, multiple fractures
|
|
What are some risk factors of PE
|
venous stasis, immobility, obesity, trauma, major sx, hx heart disease, older than 40, hx of DVT
|
|
What is compartment syndrome
|
complication of trauma in which increased pressure within a limited anatomic space compromises circulation, and fx
|
|
Waht is acute compartment syndrom usually a complication of?
|
trauma
|
|
What is chronic compartment syndrome caused by
|
people active in sports,
|
|
What are the bleeding causes of compartment syndrome?
|
vascular injury, coagulation defect
|
|
What are the excessive muscle use causes of compartment syndrom?
|
exercise, seizures, tetany eclampsia
|
|
what are the trauma causes of compartment syndrome
|
fractures, crush injuries, hypothermia, frostbite, burns, snake or spider bites
|
|
What is the leading cause of morbidity and mortality in the elderly population
|
hip fractures
|
|
risk factors for osteoporosis
|
advanced age, female and white, down estrogen levels, alzheimers, institutional residence
|
|
intracapsular hip fracture
|
femoral neck, iwthin the hip join t and capsule
|
|
extracapsular
|
outside the hip joint and capsule to an area 5 cm below lesser trochanter
|
|
S/S of hip fracture
|
severe pain at fracture site, inability to move leg, external rotation, shortening,
|
|
Nsg management of hip fx
|
pt teaching, NV checks, anticoagulants, read pgs 1491 to 1493
|
|
Mild Class one soft tissue injuries
|
stretching ligament without tear
|
|
moderate class 2 injuries
|
several ligament fibers torn with a partial loss of function
|
|
severe, class 3 injuries
|
sever or complete disruption of the ligament with resulting instability
|
|
S/S class 1 injuries
|
mild pain, and swelling
|
|
S.S class II injuries
|
moderate pain and swelling,
|
|
Class III injuries S/S
|
sever pain, swelling joint instability and disability loss of fx
|
|
RICE
|
rest, ice, compression, elevation
|
|
how long should you ice a soft tissue structures
|
48 to 72 hours
|
|
early symptoms of RA
|
fatigue, weight loss, fever, malaise, morning stiffness, pain at rest and with movment, night pain, edema
|
|
late symptoms of RA
|
pallor, anemia, color changes, muscle weakness, joint deformities, decreased joint mobility, contractures,
|
|
in RA how long does morning stiffness last
|
greater than an hour and at least 6 weeks in duration
|
|
how long will a pt have swelling of joints for RA
|
6 weeks
|
|
Medications for RA
|
PG 1511
|
|
arthroscopy
|
endoscopic examination of a joint
|
|
arthrotomy
|
opening of a joint
|
|
arthroplasy
|
reconstruction of a joint
|
|
interposition arthroplasty
|
replacement of part of a joint with a prosthesis or with soft tissue
|
|
hemiarthroplasty
|
replacement of one articulating surface
|
|
TKA
|
total knee arthroplasty
|
|
synovectomy
|
removal of part or all of the synovial membrane
|
|
osteotomy
|
cutting a bone to change its alignment
|
|
arthrodesis
|
surgical fusion of a joint
|
|
tendon transplants
|
moving a tendon from its anatomic position
|
|
DJD
|
degenerative joint disease
|
|
OA
|
osteoarthritis
|
|
COMPARE OA AND RA
|
PG 1523
|
|
DJD and pain
|
worse with weight bearing, improves with rest, paresthesia
|
|
Pain meds for OA
|
PG 1525
|
|
Pt with Total knee
|
PG 1531
|
|
review preop and post op care for pts
|
chp 47
|
|
post op care
|
1535
|
|
home instructions for total hip pts
|
1536
|
|
review complications of total joint arthroplasties
|
pg 1541
|
|
causes of secondary gout
|
1541
|
|
what is podagra
|
food pain
|
|
lab studies and gout
|
increased uric acid levels usually 24 hours
|
|
good choice for therapy for pts with gout
|
NSAIDS
|
|
red wold
|
systemic lupus erythematous
|
|
Who does SLE usually affect?
|
women of childbearing age
|
|
LUPUS CLASSIFICATIONS
|
1549
|
|
what is the most common cause of death in lupus
|
kidney failure
|
|
risk factors for osteoporosis
|
aging, female, nulliparity, family hx, vit D deficiency, sedentary lifestly,
|
|
what is the most common bone disorder in the western world
|
osteoporosis
|
|
What are the two types of osteoporosis
|
type 1: post menopausal
Type 2: senile |
|
DIFFERENCES BETWEEN TYPES 1 and 2 osteoporosis
|
PG 1556
|
|
SPA
|
single photon absorptiometry
|
|
SXA
|
single xray absorptionmetry
|
|
DPA
|
dual photon absorptionmetry
|
|
DEXA
|
dual energy absorptiometry
|
|
QCT
|
quantitative CT
|
|
QUS
|
quantitative ultrasound
|
|
common meds for osteoporosis
|
PG 1560
|
|
nsg management of pt with osteoporosis
|
starts pg 1562
|
|
what is another name for infectious bone disease?
|
osteomyelitis
|
|
What are contiguous focus or exogenous osteomyelitis caused by?
|
pathogen from outside the body
|
|
what is the most common offending organism for exogenous osteomyelitis
|
staph aureus
|
|
what type of osteomyelitis is caused by bloodborne pathogens originating from infectious sites iwthin the body
|
hematogenous osteomyelitis
|
|
which type of osteomyelitis is most commonly found in infants, children and older adults
|
hematogenous osteomyelitis
|
|
What is stage 1 osteomyelitis called
|
medullary
|
|
what is stage 2 osteomyelitis called?
|
superficial
|
|
what is stage 3 osteomyelitis called?
|
localized
|
|
what is stage 4 osteomyelitis called?
|
diffuse
|
|
in osteomyelitis, what happens to WBCs ESRs and C reactive protein levels
|
increases
|
|
what are the goals of treatment of osteomyelitis
|
complete removal of dad bone and affected soft tissue, control of infection, elimination of dead space
|
|
what is external fixation?
|
transfixing pins are inserted through the bone above and below the fracture and then attached to a rigid external frame
|
|
what is orthopedic sx?
|
various sx procedures involving the skeletal system and its joints, muscles, and associated structures
|
|
what is a bone graft?
|
taking one part of a bone and placing it somewhere else to help another bone heal
|
|
what are the purposes of orthopedic sx
|
reconstruction, replacement, removeal, repair
|
|
what type of hip fracture occurs at the head and neck
|
intracapsular
|
|
what type of hip fracture occurs at the trachanter
|
extracapsular
|
|
what type of hip fracture occurs under the trochanter
|
subtrochanteric
|
|
what are most hip fractures caused by
|
falls
|
|
are hip fractures medical emergencies
|
yes
|
|
what are some nsg interventions for a person with a hip fracture
|
prepare sx, traction care, abductor pillow, trochanter roll, pain control, reorient
|
|
what is a stretch or tear of a ligament
|
sprain
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what is a twist, pull and or tear that may involve muscles or tendons
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strain
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what is the etiology of a sprain or a strain
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direct or indirect trauma, overuse or prolonged repetive motion, inadequate rest during intensive training
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how are sprains classified
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based on degree of ligament injury
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what is a chronic progressive disease involving inflammation of synovial joints
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RA
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at what age does RA occur
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all ages
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What is the known cause for RA
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there is not one, thought to be autoimmune
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when is RA exacerbated
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increased physical or emotional stress
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what does RA affect
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may affect only joints, or may extend to body organs and blood value
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for RA how is nsg care directed?
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relievign painand maintaining function
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another name for osteoarthritis
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degenerative joint disease
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what is a slowly progresive disorder of articulation joints esp weight bearing joints
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osteoarthritis
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Where is osteoarthritis common?
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feet knees hips back
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what areas are damage from osteoarthritis limitied too?
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to joint and surrounding tisse
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what is the etiology of osteoarthritis
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cartilage degeneration causes bones to rub against each other, pain and decreased function of joints
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what refers to reconstruction or replacement of a diseased or damaged joint
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arthroplasty
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what does an arthroplasty do?
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reduces or eliminates pain, restores fx, provides joint stability, prevent complications,
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what are the common sites of arthroplasty
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hip knee
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what type of blood transfusion can you do with an arthroplasty
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auto-transfusion
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what are some nsg interventions of hip fx's
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avoid extremes of internal rotation
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what are some home instructions for hip care
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pain management, dsg changes, monitor for infection, monitor and adjustment of coagulation studies, exercise programs
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What type of antibiotics are given with a hip
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prophylactic antibiotics
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What do you do when positioning a knee
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avoid hyperflexion, and use pillows
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what type of machine to some people wake up in after a TKA
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CPM machine
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What are the home instructions for a knee sx
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weight bearing restrictions, exercises, prophylactic antibiotics, routine follow up
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what is a metabolic disease marked by urate crystal deposits in joints that cause local irritation and inflammatory responses
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gout
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what is the primary form of gout caused by
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hereditary
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how is the secondary form of gout received
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acquired
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what is gout char. by?
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recurring attacks of acute joint inflammation
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Gout is the inherited abnormality in the bodies ability to process what?
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uric acid
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what is hyperuricemia caused by?
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increased purine synthesis and or decreased renal excretion of uric acid
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what can an elevated serum uric acid level be caused by
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prolonged fasting and excessive alcohol intake
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what are some risk factors for gout
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increased alcohol intake, chemo and a decreased renal system
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what are some symptoms of gout
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inflammation, pain, no pressure
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what are some precipitating factors of gout
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dehydration, and stress
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what lab test are used to dx gout
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WBC, CBC renal panel
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what meds are used for Gout
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anti inflammatory, colchicines, NSAIDS, corticosteroids,
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What is a chronic systemic inflammatory disease affecting multiple body systems
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lupus SLE
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DLE
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a form of lupus affecting the skin only
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what is the more common form of lupus
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SLe
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when do you have a good prognosis with lupus
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early detection and treatment
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what do most pts with lupus usually die from
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renal failure
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what is a disease char by low bone mass and structural deterioratoion of bone tissue causing the bone to becomefragile and more susceptible to fxs
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osteoporosis
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factors that influence osteoporosis
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again, bone resorption greater than bone formation
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what electrolye decreases with osteoporosis
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calcium
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who is at the greatest risk for osteoporosis
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females,
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what are some common meds for osteoporosis
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estrogen, calcitronin, fosamax, evista, actonel
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what is an acute or chronic infection of the bone usually caused by staph aureus org
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osteomyelitis
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what causes a direct osteomyelitis
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invasive procedures
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what is another name for indirect osteomyelitis
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hematogenous dissemination
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what type of osteomyelitis is spread of the infectious organism through the blood
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indirect
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what are some medical interventions for osteomyelitis
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debridement, grafts, flaps, stabilization, antibiotic beads, revascularization procedures, hyperbaric O2
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what are solutes that are found in body fluids
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electrolytes
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what happens when solutes dissolve
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form ions
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what are some sources of electrolytes
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all food and fluids are normal, meds, IV and hyperalimentation abnormal
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what are the roles of electrolytes
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conduct electricity across cell membranes, maintain osmolality, reg bal of acid and bases, adi in neurologic and neuromuscular conduction, enzyme reaction
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What do electrolytes balance
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electrical neutrality, move from one side of the cell membrane to another to maintain neutral state
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ICF
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potassium, phosphorus
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ECF
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sodium, protein, bicarb, chloride
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how are the concentrations of electrolytes expressed as
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mEq/L or mg/dL
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what increased renal excretion
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diuretics
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increased GI eliminiation increases
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hydrogen and potassium loss
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decreased GI elimination decreases
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bicarbonate lost
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what are the types of renal electrolyte regulation
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glmerular, tubular, secreion
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what is secretion electrolyte regulation
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electrolyte moves from the blood into the tubule
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what type of renal regulation is like a sponge
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tubular
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what type of renal regulation is like a coffee filter
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glomerular
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what enhances the release of aldosterone
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ACTH
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what acts to reabsord Na
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aldosterone
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when aldosterone acts to reabsorb sodium, what happens to potassium
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it is excreted
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where are electrolypes secreted, absorbed, and exchanged
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GI tract
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where does exchange between anions and cations occur
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small bowel
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what is the normal range for sodium
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130-145
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what are the functions of sodium
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impulse transmission, influences level of K+ and Cl, assist with acid/base balance
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what determines osmolarity of the ECF and regulates body water
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sodium
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what does sodium regulate in the renal systen
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filtration and reabsorption
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what does sodium regulate in the endocrine system
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secretes aldosteron and ADH
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what is hyponatremia
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sodium deficiency less than 135 meg/l resulting from excessive sodium loss or excessive water gain
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what is hypernatremia
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sodium excess, na level above 145, gain in na in excess of water or a loss of water in excess of sodium
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what is the etiology of hypernatremia
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water loss, inadequate water replacement, inability to swallow, excessive sodium intake
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nsg management for hypernatremia
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maintian normal fluid balance, protect from injury, prevention
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what is the normal range for potassium
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3.5 to 5.5
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what does K+ exchange with to regulate osmolarity of ECF
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sodium
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what balances the electrical potential b/t ICF and ECF
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potassium
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what causes neuromuscular contractions
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potassium
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what type of muscle activity does potassium control
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skeletal, smooth, cardiac
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what maintains the acid-base level
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potassium
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what mechanism dos potassium regulate
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renin-aldosterone mechanism
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what is hypokalemia
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K+ deficiency
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what is the cause of hypokalemia
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inadequate dietary K+ intake, excessive ions, metabolic akalosis, hyperaldosteroneism
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what is hyperkalemia
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K+ excess
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what is the etiology of hyperkalemia
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decreased renal excretion, hypoaldosteroneism, acidosis, severe tissue trauma, excessive intact
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nsg management of hyperkalemia
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therapy to reduce level, kayexalate, calcium gluconate, sodium bicarb, reg insulin, glucose hemodialisis
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|
normal range for calcium
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8.5-10 mg/dl or 4.5 to 5.5 meq/l
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what is calcium regulated with
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magnesium and phosphate
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what controls bone and teen strength and rigidity
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calcium
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what is calcium bound to
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protein
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what is the enzymatic co factor for blood clotting
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calcium
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what regulates cell membrane structure and function
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calcium
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what helps K+ to reg. the contraction of skeletal smooth and cardiac muscle
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calcium
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what does calcium regulate
|
GI absorption and Vit. D,
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how is calcium handled in the renal system
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filtered and reabsorbed
|
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how does the endocrine system interact with calcium
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calcitonin and parathyroid gland
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what is hypocalcemia
|
calcium deficiency
|
|
what is hypocalcemia primarily caused by
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surical removal of the thyroid
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what disease causes abnormal absorption of calcium in the GI tract
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pancreatitis
|
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what can inadequate levels of Vit D cause
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hypocalcemia
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can renal failure cause hypocalcemia
|
yes
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nsg management for hypocalcemia
|
calcium replacements, precautions, admin Vit D, patient teach, monitor level
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hypercalcemia
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excess level of calcium
|
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etiology fo hypercalcemia
|
excessive admin or intake, prolonged immobilization, decreased renal excretion, hyperparathyroidism
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|
what can help reduce calcium levels
|
iv saline, iv phosphate, lasix,
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