Exam 2 - chronic illness part 2

Question 1

what is the most serious complication of GERD?

Answer 1

aspiration pneumonia

Question 2

what are modifiable risk factors of osteoporosis?

Answer 2

• underweight
• low calcium intake
• low estrogen
• low testosterone
• inadequate exercise
• steroids & anticonvulsants
• excess coffee & EtOH
• smoking

Question 3

why does menopause accelerate osteoporosis in women?

Answer 3

estrogen deficiency

Question 4

at what age do women need to be screened for osteoporosis?

Answer 4

≥ 65

Question 5

what are the diagnostic tests for osteoporosis?

Answer 5

• DEXA scan
• T-score

Question 6

T-score parameters for osteopenia

Answer 6

-1 to -2.5

Question 7

T-score parameters for osteoporosis

Answer 7

> -2.5

Question 8

what are the nursing interventions for osteoporosis?

Answer 8

• weight training
• adequate Calcium & Vitamin D
• fall preventions
• administering Bisphosphonates (Fosamax)

Question 9

what is the teaching for Bisphosphonate medications?

Answer 9

• take in the AM
• 30 minutes before breakfast
• take with full glass of water

Question 10

what are some side effects of Bisphosphonates?

Answer 10

• hypokalemia
• abdominal pain
• musculoskeletal pain
• NV
• gas

Question 11

what is a common symptom of osteoarthritis?

Answer 11

pain with activity, relief with rest

Question 12

what are the deformities associated with osteoarthiritis?

Answer 12

• Heberden’s node
• Bouchard’s node

Question 13

in which conditions is Bouchard’s node present?

Answer 13

• Rheumatoid Arthritis
• Osteoarthritis

Question 14

what are the interventions for osteoarthiritis?

Answer 14

• weight loss
• enhance strength & flexibility
• hot / cold therapy
• adaptive devices

Question 15

what are examples of adaptive devices for OA?

Answer 15

• cane
• shoe lift
• knee brace

Question 16

what are the medications for OA?

Answer 16

• acetaminophen
• NSAID
• steroids (reduce inflammation)
• hyaluronic acid (joint lubrication)

Question 17

what are the interventions for RA?

Answer 17

• pain management
• administer Methotrexate (DMARD)

Question 18

RA does not have Heberden’s nodes

Answer 18

true

Question 19

what are the surgical interventions for OA?

Answer 19

• arthroscopy
• total joint replacement

Question 20

what are the benefits of surgical interventions for OA?

Answer 20

reduces intractable pain & restores all or some joint function

Question 21

what are the causes of hyperthyroidism?

Answer 21

• toxic goiter
• Grave’s disease

Question 22

which gender is most likely to develop hyperthyroidism?

Answer 22

female

Question 23

which tests assess thyroid function?

Answer 23

• thyrotropin-releasing hormone stimulation test
• thyroid scan
• radioactive iodine uptake

Question 24

what substances should be avoided before testing thyroid function?

Answer 24

• hormones
• steroids
• foods with iodine

Question 25

how does hyperthyroidism present in older adults?

Answer 25

- tachycardia - tremors - weight loss

Question 26

what are the types of medications for hyperthyroidism?

Answer 26

- anti-thyroid agents - iodides - beta blockers - radioactive iodine

Question 27

what is the MOA of anti-thyroid agents?

Answer 27

blocks thyroid hormone production

Question 28

examples of anti-thyroid agents

Answer 28

- Methimazole - Propylthiouracil

Question 29

what is the MOA of iodides?

Answer 29

inhibits thyroid hormone secretion

Question 30

which iodide is indicated for a *thyroid storm*?

Answer 30

Saturated Solution of Potassium Iodide (SSKI)

Question 31

what is the MOA of radioactive iodine?

Answer 31

shinks & destroys thyroid gland

Question 32

what are the interventions for thyrotoxicosis?

Answer 32

- regulate temperature with ice - lower the levels of TH - replace fluid & electrolytes - stabilize cardiac function

Question 33

which medication is contraindicated with thyroid storm?

Answer 33

aspirin

Question 34

how does hypothyroidism manifest in older adults?

Answer 34

- slowed mentation - gait disturbances - fatigue - weakness - cold intolerance

Question 35

nursing care for patients with hypothyroidism

Answer 35

- prevent chilling, constipation, skin breakdown, infection - assess for edema & tachycardia - lifelong treatment of levothyroxine

Question 36

what is the major complication of hypothyroidism?

Answer 36

myxedema coma

Question 37

levothyroxine can cause digoxin toxicity

Answer 37

true

Question 38

what are the manifestations of myxedema coma?

Answer 38

- hypothermia - depression / unconsciousness - hypoventilation - hypotension - bradycardia | low temp, mood, RR, BP, HR

Question 39

how can the nurse treat myxedema coma?

Answer 39

- stabilize vitals - slow thyroid hormone replacement

Question 40

how is prostate cancer detected?

Answer 40

screening

Question 41

what is the most common cancer in men *(not related to skin)*?

Answer 41

prostate cancer

Question 42

how does PC manifest?

Answer 42

- urinary retention - hematuria - back pain - cachexia - bone tenderness - lower lymphedema - adenopathy

Question 43

what are the screening methods for PC?

Answer 43

- digital rectal exam - prostate-specific antigen - biopsy

Question 44

at what age is PC screening recommended?

Answer 44

55 - 69 years old

Question 45

which group of men has the highest likelihood of developing PC?

Answer 45

African-Americans

Question 46

the risk for PC increases as PSA results increase

Answer 46

true

Question 47

there is a 50% chance of developing PC with which level of PSA?

Answer 47

10ng/mL

Question 48

what are the nursing considerations for anti-thyroid agents?

Answer 48

- report any swelling in lymph nodes - assess thyroid function tests - give at same time each day - give with food - monitor INR

Question 49

why are fall preventions in place for older adults with osteoporosis?

Answer 49

prevent hip fractures

Question 50

what is *cogwheel rigidity*?

Answer 50

- small jerking movements - muscle rigidity

Question 51

this is a movement disorder that involves being frozen

Answer 51

akinesia

Question 52

what are the manifestations of *bradykinesia* & *dyskinesia*?

Answer 52

- difficulty starting, continuing, or coordinating movements - shuffling - akinesia

Question 53

what are *resting* or *non-intention* tremors?

Answer 53

- purposeless tremors that disappear with sleep - ***pill-rolling*** - small handwriting - monotone voice