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Ellie-NUR 120 > Mobility pt 2 > Flashcards

Mobility pt 2 Flashcards

(79 cards)

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1
Q

what are pt care ergonomics

A

proper body mechanics

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2
Q

what are some proper body mechanics

A

bend w/ knees
carry pt close to body
raise bed
ask for help
lift @ same time
use assisted lifts
feet shoulder width apart
face toward object lifting
lower side-rail
use step stools

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3
Q

what does deconditioned mean

A

loss of physical fitness

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4
Q

what part of the brain is responsible for mobility

A

motor cortex (frontal lobe)

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5
Q

what are some factors affected by immobility

A

musculoskeletal system
cardiovascular system
respiratory system
urinary system
integumentary system
gastrointestinal system
metabolic system
mental health

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6
Q

what are some effects of immobility

A

decreased muscle size
decreased tone and strength
decreased joint mobility and flexibility
bone demineralization
contractures or ankylosis

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7
Q

what is the best way to avoid osetoporosis

A

walking

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8
Q

what is stasis

A

slow

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9
Q

what are the effects of immobility on the cardiovascular system

A

increased cardiac workload
orthostatic hypotension
venous stasis
venous thrombosis

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10
Q

what is venous thrombosis

A

clot

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11
Q

what does venous stasis lead to

A

venous thrombosis

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12
Q

what are some effect of immobility on the respiratory system

A

decreased ventilatory effort (harder to breathe lying down)
increased respiratory secretions
decrease in depth and rate of respirations
poor exchange of carbon dioxide and o2
atelectasis

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13
Q

what is atelectasis

A

incomplete expansion or collapse of lung tissue

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14
Q

what are some effects of immobility on the urinary system

A

increased urinary stasis
increased risk of renal calculi
decreased bladder tone

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15
Q

what does urinary stasis mean

A

urine stays in bladder and can lead to uti

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16
Q

what are renal calculi

A

kidney stones

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17
Q

what does decreased bladder tone lead to

A

incontinence

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18
Q

what are some effect of immobility on integumentary system

A

increased risk of skin breakdown
increased risk of pressure injury

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19
Q

how often are you supposed to turn pt’s

A

every 2 hrs

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20
Q

what are some effects of immobility on gi system

A

disturbance in appetite
altered digestion
altered metabolism of nutrients
decreased peristalsis

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21
Q

what are some effects of immobility on metabolic system

A

increase for electrolyte imbalance
altered exchange if nutrients and gases

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22
Q

what are some effects of immobility on mental health

A

decrease self-concept
decrease social interaction
increase sense of powerlessness
increased risk of depression

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23
Q

what are 2 common disorders of the joints and bones

A

rheumatoid arthritis and osteoporosis

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24
Q

what are some characteristics of rheumatoid arthritis

A

Inflammatory, systemic,
autoimmune
Affects synovial joints primarily
Affects men and women
Results in joint stiffness, pain,
swelling and deformity

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25
what is the goal of treating rheumatoid arthritis
decrease pain and inflammation prevent disabling deformities
26
what are the 3 main types of drugs to treat RA
NSAID's (nonsteroidal anti-inflammatory drugs) glucocorticoids DMARD's (disease modifying antirheumatic drugs)
27
what are some characteristics of DMARD's
Immunosuppressive Decrease joint inflammation Symptomatic relief Delay progression 2 types: Non Biologic and Biologic on the med continuously
28
what is the prototype of non biologic antimetabolite
methotrexate
29
what class is methotrexate
antirheumatic
30
what is the pharmacologic action of methotrexate
immunosuppression
31
what are the adverse reactions to methotrexate
Dizziness headache blurred vision nausea and vomiting bone marrow suppression gastrointestinal ulceration and pulmonary fibrosis teratogenic effects
32
what is pulmonary fibrosis
damage on lungs
33
what are the interventions for methotrexate
monitor lab values: RBC,WBC & Platelets Liver Function abdominal pain diarrhea nutritional status GI bleed Respiratory distress jaundice
34
how do you administer methotrexate
once a week orally, subcutaneously, or IM
35
what are some contraindications for methotrexate
clients with liver insufficiency renal insufficiency or alcoholism pregnancy and breast feeding
36
what are some precautions for methotrexate
caution if client has bacterial or viral infection or peptic ulcer disease or ulcerative colitis
37
what are some interactions of methotrexate
Can cause digoxin toxicity NSAID’s and sulfonamide toxicity caffeine decreases effectiveness warfarin increases the risk for bleeding alcohol ingestion increases chance of hepatotoxicity
38
what is the prototype of biologic antimetabolite
etanercept
39
what class is etanercept
antirheumatic
40
what is the pharmacologic action of etanercept
inactivation of tumor necrosis factor
41
what are some adverse reactions with etanercept
Dizziness pharyngitis upper respiratory infections abdominal pain psoriasis pancytopenia heart failure reactivation of latent TB or new development of TB
42
what are some interventions of etanercept
Monitor signs of infection cough shortness of breath elevated blood pressure and heart rate production of pink sputum TB test
43
how is etanercept administered
once a week subcutaneously
44
what are some contraindications/precautions of etanercept
active infection hematologic disease, or malignancy autoimmune disorders of the central nervous system such as multiple sclerosis
45
what are some interactions of etanercept
Can cause bone marrow suppression when used in clients taking chemotherapeutic drugs do not give with anakinra due to increased risk of infection avoid use of live vaccines
46
what are some characteristics of osteoporosis
Reduces bone mass decreases bone density progressive women post menopausal @ higher risk men @ risk as aging- reduction of testosterone, long term glucocorticoid therapy, alc abuse, caffeine, tobacco, and non weight bearing disorders Results in increased risk for fractures: most common sites are hip, wrist and spine
47
what does SERM stand for
selective estrogen receptor modulators
48
what is the prototype of SERM's
raloxifene
49
what is the class of raloxifene
bone absorption inhibitor
50
what is the pharmacologic action of raloxifene
activates estrogen receptors decreasing bone loss maintaining bone mineral density
51
what are some adverse reactions with raloxifene
increased risk of stroke pulmonary embolism deep vein thrombosis hot flashes teratogenic
52
what are some interventions for raloxifene
Monitor bone density signs of DVT PE and cholesterol hormones and fibrinogen
53
how do you administer raloxifene
orally daily w/ or w/out food take w/ vit D and calcium perform weight bearing exercises
54
what are some contraindications of raloxifene
clients with DVT or history of DVT pregnancy and breast feeding elevated serum lipid levels
55
what are some interactions with raloxifene
do not take concurrently w/ estrogen
56
what is the prototype of bisphosphonate
alendronate
57
what class is alendronate
bone absorption inhibitor
58
what is the pharmacologic action of alendronate
decrease bone resorption by inhibiting activity of osteoclasts
59
what are some adverse reactions of alendronate
esophagitis nausea vomiting abdominal pain muscle and joint pain eye and vision changes
60
what are some interventions for alendronate
monitor for decreased bone resorption and changes in vision manage muscle and joint pain
61
how do you administer alendronate
orally daily w/ glass of water and 30 minutes before other drugs, food, or drinks pt needs to remain sitting or standing for 30 min after taking drug
62
what are some contraindications of alendronate
clients with esophageal strictures or difficulty swallowing renal insufficiency hypocalcemia upper GI disorders infections liver disease heart failure
63
what are some interactions with alendronate
do not take calcium supplements or dairy products within 30 minutes of administration
64
what is the prototype of calcitonin
calcitonin-salmon
65
what is the class of calcitonin
hypocalcemic
66
what is the pharmacologic action of calcitonin
decrease bone resorption by inhibiting activity of osteoclasts and increasing excretion of calcium
67
what are some adverse reactions with calcitonin
allergy to salmon or gelatin diluent can cause anaphylaxis hypocalcemia nasal dryness headaches epistaxis nausea and vomiting polyuria
68
what are some interventions of calcitonin
monitor for signs of hypocalcemia such as muscle spams, tinging of fingers and toes, and low serum calcium levels, allergic reactions and anaphylaxis
69
how do you administer calcitonin
intranasal, subcutaneous, or IM protect from light and refrigerate encourage high calcium and vit d diet
70
what are some contraindications of calcitonin
pt w/ allergies to salmon or other fish protein
71
what are some interactions of calcitonin
monitor closely if pt is also taking lithium
72
what is the prototype of calcium supplements
calcium citrate and calcium carbonate
73
what is the class of calcium supplements
mineral and electrolyte supplements
74
what is the pharmacologic action of calcium supplements
non dietary form of calcium
75
what are some adverse reactions to calcium supplements
hypercalcemia nausea and vomiting constipation polyuria depression renal calculi hypercalciuria
76
what are some interventions for calcium supplements
Monitor serum calcium decreased gastric and intestinal motility urine output flank pain blood in urine
77
how do you administer calcium supplements
orally or IV give 1 before or 2 hrs after glucocorticoids, thyroid supplements, tetracycline, and quinolone take w/ glass of water
78
what are some contraindications of calcium supplements
clients with hypercalcemia or low phosphate level kidney stones cardiac arrythmias
79
what are some interactions with calcium supplements
monitor closely if client also taking digoxin for digoxin toxicity clients taking a thiazide diuretic are at increased risk for hypercalcemia Do not take close to a meal when eating cereals, rhubarb and spinach as it decreases absorption

Ellie-NUR 120 (8 decks)

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