Cyndi - Week 6 - Exam 3 Flashcards

Question

what are meds prescribed as tx for osteoporosis?

Answer 1

* Calcium, Vit D supplements * Bisphosphonates * Calcitonin * Selective estrogen receptor modulator * Human parathyroid hormone * Monoclonal antibody

Answer 2

dietary intake, supplements

Answer 3

Alendronate (Fosamax) – inhibit bone resorption – can be taken oral, SQ, or IV – taken with water but not food, need to be upright for at least 30 min after taking, has potential side effects, including jaw necrosi

Answer 4

Calcimar ‐active form of Vit D – inhibits bone resorption by acting on osteoclasts. Given IM or intranasal. Need to take calcium supplements

Answer 5

Raloxifene (Evista)‐ reduces bone resorption without stimulating hormonal tissues

Answer 6

Teriparatide (Forteo) – anabolic skeletal effects ‐ increases the action of osteoblasts – stimulates bone growth – SQ

Answer 7

Denosumab (Prolia) – inhibits activity of osteoclasts by binding to a protein that osteoclasts need to function – SQ admin

Answer 8

Infection of bone, bone marrow, soft tissue

Answer 9

staph aureus

Answer 10

Direct entry ‐ open wound, implant | Indirect entry – blunt trauma, vascular insufficiency, infection beginning elsewhere

Answer 11

Acute – initial infection and < 1 month Chronic – oqngoing infection > 1 month • Pressure from infection may prevent ATBs and WBCs from reaching area

Answer 12

• Persistent, severe, and increasing bone pain • Wound draining purulent fluid • Signs and symptoms of systemic infection: temperature, tachycardia, and tachypnea • Signs of localized infection: edema, pain, warmth, redness, restricted movement • Chronic condition (>1 mo) may not have systemic manifestations as body adapt

Answer 13

sepsis and amputation

Answer 14

- Labs related to infection, bone marrow health - bone or soft tissue biopsy of area - wound cultures

Answer 15

– WBC may be normal or elevated, neutrophils may be elevated – ESR elevated in 90%, CRP may be elevated also – Blood cultures positive in 50%

Answer 16

– CT guided needle aspiration

Answer 17

– Fail to identify organism in 25% of cases

Answer 18

Complete rest of limb – non‐weight bearing!! • IV Antibiotics (4‐6 weeks): – Culture and Sensitivity from wound culture or biopsy, troughs for some ATBs – Home health RN and PICC line or skilled nursing facility • Pain medication • Excellent nutrition • Sterile dressings – may have wound vac • Surgery to debride/remove necrotic bone • Physical Therapy as needed • Amputation in worst case scenario

Answer 19

Primary malignant tumor in bone

Answer 20

– Aggressive – Most common in child or young adult – More common in males (60%) – Most often in long bones or pelvis, in metaphyseal area – Benign tumor (osteochondroma) more common – Tumor can begin as benign but turn malignant (Osteoclastoma) ***not the same as a metastatic tumor from another distant primary site

Answer 21

• Gradual onset of pain and swelling – Especially when weight‐bearing • May have spontaneous fracture or injury • Anemia • Infection • Edema and discoloration of skin at site

Answer 22

* Radiography - PET scan * Labs: ↑ alk phos (ALP) and Ca++/ ↓ blood component levels * Biopsy

Answer 23

``` -Surgery • Amputation • Rotationplasty h • Limb salvage • Pain management • May be palliative - Radiation • External beam or radioactive drug - Chemotherapy - Nursing role ‐ care of ped pt, education ```

Answer 24

One of a group of genetic muscular diseases | – Progressive weakness and wasting of skeletal muscles due to a mutation of dystrophin

Answer 25

– Onset at 3 ‐ 7 years old ‐ milestones had been met prior – May have a learning disorder or cognitive deficit • Deficiency of dystrophin isoforms in brain – Death typically late teens/young adult • With good care can live longer

Answer 26

• X‐linked recessive trait – Almost always male (mother as carrier) • 65% have positive family history • 1/3 ‐ fresh mutation

Answer 27

• Dystrophin helps muscles attach to surrounding structures – Calf and arm muscles initially hypertrophy (pseudohypertrophy) – Progressive generalized weakness in adolescence – Profound muscular atrophy in later stages • Nervous system sensation intact • Bowel and bladder control intact • Death usually from respiratory or cardiac failure

Answer 28

Clinical picture a big part of diagnosis: • Familial history, male, waddling gait, lordosis, Gower’s sign, falls, delay in development Labs - Creatinine kinase (CK) Muscle biopsy Electromyogram testing (EMG) Electrocardiogram (EKG) Genetic testing and counseling for family

Answer 29

FALSE no cure

Answer 30

• Steroids can help to slow disease progression • Active/independent for as long as possible – Braces, standing frames, lifts, wheelchairs when needed • Prevent contractures, pneumonia, ulcers • Respiratory support when needed • No special diet • Help family and patient cope with progressive incapacity – Connect with resources – quality of life www.mda.org – Promote sociability, school

Cyndi - Week 6 - Exam 3 Flashcards

(55 cards)