ch 61 highlights

Question 1

Vit d requirements in relation to age

Answer 1

increases with age

Question 2

cells that resorb (break down) old bone

Answer 2

osteoclasts

Question 3

cells that deposit new bone and increase bone madss

Answer 3

osteoblasts

Question 4

foods that suppress calcium absorption

Answer 4

oxalic acid - found in spinach, rhubarb, swiss chard and beets

Question 5

calcium reduces the effectiveness of what antibiotics

Answer 5

quinolones and tetracyclines - take 2 hours apart from the med

Question 6

if have gi upset with calcium carbonate

Answer 6

switch to calcium citrate - better absorbed/tolerated

Question 7

calcium is excreted in the

Answer 7

kidney

Question 8

Bisphosphonates

Answer 8

-ate
Alendronate
Risedronate
Ibandronate

Zoledronic Acid

Question 9

what is your first line Bisphosphonates

Answer 9

Alendronate

Question 10

patient education alendronate

Answer 10

can cause esophagitis

Take with full glass of water and sit/stand for at least 30 min after

Question 11

use for Risedronate

Answer 11

approved for postmenopausal osteoporosis

male osteoporosis, GIOP and Paget disease

Question 12

Bisphosphonate that is only approved for postmenopausal osteoporosis

Answer 12

Ibandronate (Boniva)

Question 13

what will decrease calcium

Answer 13

glucocorticoids

leafy greens

Question 14

To ensure adequate absorption of Calcium, no more than ____mg at one time

Answer 14

600

Question 15

calcium decreases absorption of what hormones

Answer 15

thyroid

Question 16

what type of calcium is more consistent bioavailability

Answer 16

chewable

Question 17

how to take bisphosphonates

Answer 17

take these drugs in thte

Question 18

Perenteral calcium may cause severe bradycardia in pt taking

Answer 18

Digoxin - monitor HR closely

Question 19

Zoledronate will increase/decrease r/o osteonecrosis of jaw as compared to Alendronate (Fosamax)

Answer 19

increased

Question 20

Zoledronate is given

Answer 20

IV 1-2 years

Question 21

zoledronate the pt will need

Answer 21

regular dental checks to monitor for osteonecrosis of jaw

Question 22

adequate amount of Vit D are gained through

Answer 22

fortified foods
supplements
exposure to sunlight

Question 23

Which is preferred vit D 3 or Vit D2

Answer 23

Vit D3

Question 24

If Ca is not sufficient will vit D be absorbed

Answer 24

Vit D can promote bone decalcification if CA is not sufficient

Question 25

Vit D acts to increase Calcium and phosphorous absorption from

Answer 25

intestine

Question 26

Treatment for osteoporosis that can protect against breast cancer

Answer 26

Raloxifene (Evista)

Question 27

Pt taking risedronate (Actonel) for osteoporosis is having diarrhea, rash, nausea, arthralgia and headache. What will the nurse tell them

Answer 27

This is common side effects and not a symptom of toxicity

Question 28

Forteo pen needs to be replaced every

Answer 28

28 days

Question 29

symptoms of hypocalcemia

Answer 29

``` weakness fatigue n/v constipation nocturia ```

Question 30

vit d tox can occur

Answer 30

stop vit d, reduce ca and increase fluids

Question 31

Taking Raloxifene (Evista) be cautious on long flights for

Answer 31

DVT