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NUR 211 Krissa > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

Bone cells that break down bone

A

Osteoclasts

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2
Q

Bone cells that rebuild bone

A

Osteoblasts

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3
Q

Term for bone loss

A

Osteopenia

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4
Q

Most common areas of bone loss

A

Lumbar spine
Hip
Distal radius (wrist)

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5
Q

Risk factors for osteoporosis

A
  • Cigarette smoking
  • Early menopause
  • Excessive use of alcohol
  • Family history
  • Female gender
  • Increasing age
  • Decreased calcium intake
  • Sedentary lifestyle/Immobility
  • Thin, small frame
  • White (European descent) or Asian Race
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6
Q

What is the name if this condition?

  • Bone demineralization occurs through loss of calcium and phosphorous salts leading to fragile bones and increased risk for fracture
  • Bone reabsorption accelerates, while bone formation decreases
A

Osteoporosis

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7
Q

What type of osteoporosis is this?

Occurs most often in postmenopausal women and men with low Testosterone levels

A

Primary

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8
Q

What type of osteoporosis is this?

Prolonged steroid use, thyroid-reducing medications, aluminum-containing antacids, or antiseizure medications

A

Secondary

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9
Q

All of the following are clinical manifestations of what?

“Silent Disease” because patients are usually not diagnosed until a fracture occurs after an unremarkable fall or strain
“Dowager’s Hump” – kyphosis of the dorsal spine
Loss of height (as much as 2 -3 inches)
Back pain (sharp or acute)
Pain increased with activity and relieved by rest
Restriction of movement (thoracic and lumbar regions)
Fear of falling and/or history of previous falls
Previous fractures
Constipation
Abdominal distention
Reflux esophagitis

A

Osteoporosis

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10
Q

kyphosis of the dorsal spine

A

Dowager’s hump

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11
Q

Normal T-score on a DEXA scan

A

-1.0 or higher

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12
Q

Abnormal T-score on a dexa scan

A

Anything below -1.0

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13
Q

T-Score on a DEXA scan between -1.0 and -2.5 indicates what?

A

Ostepenia

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14
Q

DEXA Scan -2.5 or lower

A

Osteoporosis

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15
Q

What type of test is this?

  • Gives precise body measurements at specified skeletal points throughout the body
  • Used for screening and diagnosis
  • May diagnose osteopenia or osteoporosis
A

DEXA scan

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16
Q

measures volumetric bone density of spine and hip
Used for diagnostic management (to confirm diagnosis)

A

QCT

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17
Q

Normal Calcium levels

A

9-11

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18
Q

A calcium level less than 8 indicates what?

A

Calcium deficiency

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19
Q

Normal vitamin D level

A
  • 30-50
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20
Q

Vitamin D level of 20-30 indicates what?

A

Vitamin D insufficiency

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21
Q

Level of vitamin D toxicity

A

above 50

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22
Q

The following are S/S of what?

  • Dehydration
  • Hypercalcemia
  • Kidney damage
A

Vitamin D toxicity

23
Q

How will osteoporosis patients vitamin D levels present?

A

insufficient

24
Q

Ways to prevent bone loss

A
  • Calcium with vitamin D via supplements or dietaty intake
  • 15 mins of sun exposure per day
25
Q

Calcium’s role in osteoporosis

A

maximizes bone growth early in life and maintains bone integrity later in life.

26
Q

Vitamin D’s Role on osteoporosis

A

ensures calcium absorption
These are the two most important bone supplements for advanced aging and to preserve bone health

27
Q

What medication used to treat osteoporosis is this?

  • Impedes bone resorption by stopping osteoclastic activity, increasing total bone mass
A

Bisphosphnates

28
Q

Contraindications for bisphosphonates

A
  • Clients with esophageal disorders that can impede swallowing
  • Clients who cannot sit or stand for at least 30 minutes after administering
29
Q

Adverse effects of Bisophosphonates

A

Notify care provider should be notified immediately if any of the following occur:
* Esophagitis
* Muscle pain
* Ocular problems

30
Q

How to administer bisphosphonate

A
  • In the morning before eating and drinking
  • with a full glass of water
  • Sit upright for 30 mins
  • Do not eat or drink anything for at least 30 minutes
  • Take with regular tap water for best absorption
31
Q

If a client is prescribed bisphosphonate Ibandronate must do what after taking?

A
  • Sit or stand for at least 60 mins after taking
  • no food or drink for 60 mins after taking
32
Q

What medication is this?

  • Decreases osteoclastic activity in bone, decreases mineral release and collagen breakdown, and assists with renal excretion of calcium
  • Routes of administration salmon: intranasal, SQ, or IM
A

Calcitonin-salmon or Calcitonin-human

33
Q

Special administration instructions for calcitonin

A
  • Inspect nares for irritation
  • Alternate nares for each dose
34
Q

Calcitonin human can only be given how?

A

SQ

35
Q

Patients taking calcitonin should be monitored for what?

A

Hypocalcemia

36
Q

What medication is this?

  • assists with bone remodeling and osteoclastic activity
  • Risk for causing DVT
A

Estrogen or estrogen HRT

37
Q

What medication is this?

  • Assists with bone remodeling and osteoclastic activity
  • contraindicated in clients with a history of a DVT
A

Estrogen

38
Q

Teaching with estrogen agonist

A
  • Needs to be D/C’d 72 hours before prolonged immobilization periods (extended periods of bedrest, etc.)
  • Instruct client to avoid extended periods of restricted activity (such as traveling long distances)
  • Contraindicated in pt’s with a hx of DVT
39
Q

What medication is this?

  • Stimulates new bone formation, increasing bone mass and increases osteoblastic activity
  • Given to clients at very high risk for fractures
  • Has been associated with development of Bone Cancer
A

Parathyroid Hormone

40
Q

What medicine is this?

  • Inhibits osteoclastic function, formation, and survival reduces osteoclastic bone resorption
  • Treats hypercalcemia
  • Treats bone cancer and bone problems in clients with cancer
A

Monoclonal Antibody

41
Q

Priority Nursing assessment for osteoporosis

A

Assess fall risk
Assess pain level
Assess nutritional status
Assess level of activity and exercise
Assess body image disturbances, if applicable

42
Q

Dietary teaching for Osteoporosis patients

A

protein, magnesium, vitamin K, calcium, vitamin D, vitamin C and iron, increased fluid intake

43
Q

Fall precations at home

A
  • Remove throw rugs
  • Provide adequate lighting
  • Clear walkways of clutter
  • Wear non-slip socks when walking in the house
  • Clearly mark thresholds, doorways, and steps
44
Q

What kind matress should an osteoporosis patient use?

A

Firm

45
Q

What should be applied during an acute episode of osteoporosis

A

Apply back brace to immobilize and protect vertabral column

46
Q

Client education for osteoporosis

A
  • Use of correct body mechanics
  • Exercises to strengthen core muscles to improve posture and support spine
  • Avoid activities that can cause vertebral compression
  • Diet high in protein, calcium, vitamins C and D, and iron
  • Maintain adequate fluid intake to prevent kidney stones
47
Q

What kind of exercises do osteoporosis patients need to do?
How often?
How long

A

weight bearing
3-5 times a week
for 30 minutes

48
Q

The following are sources are

Eggs
Chicken
Lean beef
Fish
Turkey
Cheese
Greek yogurt
Milk

A

Protein

49
Q

All of the following foods are rich in what?

Greens
Nuts
Seeds
Dry beans
Whole grains
Wheat germ
Wheat and oat bran

A

Magnesium Sources

50
Q

The following foods are rich in what?

Green, leafy vegetables
Soybean
Fortified meal replacement shakes

A

Vitamin K sources

51
Q

The following food is rich in what?

Dairy and fortified plant-based milks
Cheese
Yogurt
Fortified OJ
Butternut squash
Green, leafy vegetables
Avocado

A

Calcium

52
Q

The following foods are rich in what?

Fortified milk, cereal, and juices
Salmon
Eggs
Tuna and sardines
Trout
Beef liver
White mushrooms

A

Vitamin D

53
Q

To decrease bone loss osteoporosis patients should limit what?

A

Caffine
alcohol
carbonated drinks

NUR 211 Krissa (16 decks)

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