Care of Patients with Musculoskeletal Patients Flashcards Preview

Nursing 202 > Care of Patients with Musculoskeletal Patients > Flashcards

Flashcards in Care of Patients with Musculoskeletal Patients Deck (40)
Loading flashcards...
1

Osteoporosis:

chronic metabolic disease in which bone loss causes decreased density and possible fracture

2

Bone is a dynamic tissue that is constantly undergoing changes in a process called

bone remodeling

3

Osteoporosis and osteopenia (low bone mass) occur when

Osteoclastic (bone reabsorption) activity is greater than osteoblastic (bone building) activity
The result is a decreased bone mineral density (BMD): determines bone strength and peals between 25-30 years of age

4

A T-score represents the

number of standard deviations above or below the average BMD for young, healthy adults

5

Osteopenia is present when the T score is at

-1 and above -2.5

6

Osteoporosis is diagnosed when the T score is

at or lower than -2.5

7

Medicare reimburses for BMD testing every 2 yr in people ages of 65 and older who are:

Estrogen deficient
Have vertebral abnormalities
Receive long term steroid therapy
Have primary hyperparathyroidism
Being monitored while on osteoporosis therapy

8

Generalized osteoporosis involves many structures in the skeleton and is further divided into 2 categories:

Primary: occurs in postmenopausal women and in men in their seventh or eighth decade of life

Secondary: result from other medical conditions, such as hyperparathyroidism; long term drug therapy, such as with corticosteroids; or prolonged immobility, such as seen w/ spinal cord injury

9

Excessive ______ in the diet can cause calcium loss in the urine

caffeine

10

What can also reduce bone density?

Protein deficiency
Yet, excessive protein intake may increase calcium loss in the urine

11

Other risk factors of Osteoporosis:

Excessive alcohol and tobacco use

12

Kyphosis:

curvature of the thoracic spine, "dowager's hump"
-2-3 in shorter w/in previous 20 years

13

The most common type of osteoporotic fracture:

back pain accompanied by tenderness and voluntary restriction of spinal movement suggests one or more compression vertebral fractures

14

Quality of life might also be impacted by

pain, insomnia, depression, and fallophobia (fear of falling)

15

Lab assessments:

biochemical markers
Bone specific alkaline phosphate (BSAP)
Osteocalcin
N-telopeptide (NTX)
C-telopeptide (CTX)

16

Imaging assessments:

Most common: Dual x-ray absorptiometry (DXA or DEXA)
-painless scan that emits less radiation than a chest x-ray
-best tool

Peripheral quantitative ultrasound (pQUS) is an effective and low cost tool that can detect osteoporosis and predict risk for hip fracture

17

Nutrition therapy and lifestyle changes:

Avoid alcohol and caffeine
Lactose intolerance - choose a variety of soy and rice products
Calcium and Vit D are added to many fruit juices, bread, and cereal products
The promotion of a single nutrient will not prevent or treat osteoporosis
Exercise is important in prevention & management
Encourage active ROM

18

Drug therapy:

Provider may prescribe calcium and vit D supplements, bisphosphonates, or estrogen agonist/antagonists

19

Hypercalcemia can cause serious

damage to the urinary system and other body systems

20

Bisphosphonates (BPs) do what?

slow bone reabsorption by binding w/ crystal elements in bone, especially spongy, trabecular bone tissue

21

Oral BPs are commonly associated w/ a serious problem called

esophagitis (inflammation of esophagus)

22

Osteomalacia:

loss of bone related to a Vit D deficiency
Ex. rickets = children's version

23

Osteomalacia and osteoporosis can occur

at the same time

24

Manifestations of osteomalacia:

Nonspecific
Muscle weakness and bone pain may be mistaken as arthritis or another connective tissue disorder

25

Paget's disease or osteitis deformans:

chronic metabolic disorder in which bone is excessively broken down (osteoclastic activity) and re-formed (osteoblastic activity)

26

Manifestations of Paget's disease

Common:
Fragility fractures
Different size and shape of skull: soft, thick, enlarged
Deafness
Vertigo
Changes in vision, swallowing, hearing, and speech

Less common:
Hyperparathyroidism and gout
Hyperuricemia and gout occur because increased metabolic activity of bone creates an increase in nucleic acid catabolism
Increased cardiac output

27

Diagnostic assessment of Paget's disease

Serum alkaline phosphatase (ALP) and urinary hydroxyproline levels are primary lab findings

28

Drug therapy for Paget's disease

Bisphosphonates = 1st line defense
NSAIDs

29

Other interventions for Paget's

gentle massage
application of heat
exercise program

30

Bacteria, viruses, or fungi can cause infection in bone known as

osteomyelitis