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Med Surg 1 > week 5 > Flashcards

week 5 Flashcards

1
Q

dietary risk factors for osteoporosis

A

low calcium
low vitamin D & protein
excess alcohol, caffeine, & phosphorus

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2
Q

osteoporosis manifestations

A

kyphosis
back pain
shortened height
fractures

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3
Q

calcium supplement teaching

A

take w food in DIVIDED DOSES w 8oz water

less than 500 mg & Mg / vitamin D increase absorption

*monitor for consitpation & hypercalcemia

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4
Q

bisphophonates

A

alendronate
ibandronate
risedronate
zoledronic acid

**reduces osteoclast activity

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5
Q

alendronate teaching

A

empty stomach w 8 oz water before breakfast

remain upright/ambulate for 30 min after (esophagitis)

monitor bone density

report dysphagia or heartburn

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6
Q

Raloxifene

A

decreases osteoclasts & imporves bone density

DVT precaution
monitor liver
stop 72 hours before prolonged bed rest

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7
Q

method of diagnosing osteoporosis

A

DEXA scan - measures bone mineral density

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8
Q

calcitonin

A

increases calcium excretion, but helps decrease calcium levels

*monitor for hypocalcemia

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9
Q

hypocalcemia manifestations

A

tetany = involunatery muscle movements
paresthesia
muscle cramps
osteoporosis

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10
Q

calcium foods

A

dairy - milk & cheese
almonds
broccoli
kale
fortified grains

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11
Q

osteoporosis patient teachings

A

spend time in the sun
weight bearing exercise
frequent ambulation - 30 min 4x/wk
limit caffeine & smoking
rubber mats in showers
well lit halls
*NO THROW RUGS

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12
Q

s/s of osteoarthritis

A

crepitus - crunch sound
joint pain & stiffness
joint effusion
back pain
node formation - herberdens & bouchards

*pain that INCREASES W ACTIVITY
relief at rest

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13
Q

tests to diagnose Rheumatoid arthritis

A

erythrocyte sedimentation rate (ESR)
C- reactive protein (CRP)
synovial fluid aspiration
rheumatoid factor (RF)

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14
Q

range for c-reactive protein

A

0.3 to 1.3

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15
Q

pharmacology for osteoporosis

A

NSAID’s
steroids - Prednisone
Glucosamine

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16
Q

intra-articular injections

A

hyaluronic acid
glucocorticoids

17
Q

weak opiod used for osteoarthritis

A

TRAMADOL

18
Q

side effects of glucosamine

A

for osteoporosis

*headache, gi upset, drowsiness

19
Q

adverse effects of glucosamine

A

rash
increased bleeding

20
Q

rheumatoid arthritis

A

autoimmune disorder that attacks joints

21
Q

s/s of rheumatoid arthritis

A

pain AT REST
relief w activity
*systemic symptoms = low grade fever, fatigue, & anorexia
morning stiffness
fatigue
swelling in small joints
*swans neck
*boutonniere deformity

22
Q

nursing considerations for rheumatoid arthritis

A

do not elevate knees w pillow at night

low impact exercise (swimming, stationary bike, light walk)

warm shower or bath before bed (alternate hot &cold therapy)

23
Q

meds used for rheumatoid arthritis

A

NSAIDs
steroids - prednisone
methotrexate

24
Q

methotrexate considerations

A

*for rheumatoid arthritis– to stop body from attacking itself– immunosupression

folic acid to decrease risk of toxicity

no pregnancy – 3 mo after period
bleed risk - no razors
thrombocytopenia
flu vaccines okay but no live vaccines
immunocompromised - no crowds

25
Q

hydroxychloroquine considerations

A

*immunosuppressant given to decrease inflammation & fatigue

adverse effects
*vision damage - appointment every 6 to 12 mo

NOT NEEDED FOR OSTEOPOROSIS VITAMINS (calcium & vitamin d)

26
Q

range for serum uric acid

A

3.5 to 7.2

27
Q

gout

A

inflammatory disease cause bu hyperuricemia & purine metabolism

serum uric acid level > 7
*inflammed BIG TOE

28
Q

foods high in purine

A

meat :
seafood;
alcohol
whole grains
legumes

29
Q

teaching to prevent gout

A

lose weight
increase fluid intake
avoid purine foods

30
Q

gout meds

A

***not for pain
allopurinol (prevention)
colchicine (acute attack)

31
Q

medication used for pain relief w gout

A

Naproxen = nsaid or ibuprofen

32
Q

allopurinol teaching

A

prevention of gout

RASH = deadly
increase fluids
take w water
months to work

contraindicated in liver & kidney disease

33
Q

hyper vs hypo - calcemia

A

hyper = renal stones, nausea, vomiting, & constipation

hypo = twitching, tetany, & muscle spasms

34
Q

adverse effects of alendronate

A

jaw pain
blurred vision
muscle pain

35
Q

raloxifene adverse effects

A

calf tenderness
DVT risk
*prevents osteoporosis

36
Q
A

Med Surg 1 (8 decks)

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