Quiz #4 Skeletal System Flashcards
A health care professional is caring for a patient who is taking calcium supplement and reports flank pain. The health care professional should suspect the patient has which of the following?
a. Renal calculi
b. Pancreatitis
c. Liver disease
d. Hip fracture
A. Renal calculi
Calcium supplements can cause renal calculi. Patients should increase water intake while taking calcium supplements to hydrate the kidneys and report any blood in the urine or flank pain
Adverse effects of calcium
Constipation, gas, and bloating
A nurse is teaching an older adult client who has osteoporosis about beginning a program of regular physical activity. Which of the following recommendations should the nurse make?
A. Stretching exercises
B. High-impact aerobics
C. Riding a bicycle
D. Walking briskly
D. Walking briskly
because weight bearing excercises are essential for maintaining bone mass which will prevent osteoporosis.
Recommended physical activity for osteoporosis when patient is beginning a program
Consider engaging in weight-bearing exercises (walking, lifting weights). These activities promote bone rebuilding and maintenance.
A nurse is teaching a client who is starting to take alendronate effervescent tablets to treat osteoporosis. Which of the following information should the nurse include?
A. “Sit upright or stand for at least 30 minutes after taking this medication.”
B. “Take this medication with food.”
C. “Take this medication with orange juice.”
D. “Chew or suck on the tablet.
Sit up right or stand for at least 30 minutes after taking medication
the nurse should instruct the client to sit or stand for 30 min after administration of the medication to reduce prolonged contact of the medication which can cause esophagitis.
A nurse is reinforcing teaching with a client who has osteoporosis and is 2 points prescribed alendronate 70 mg PO weekly. Which of the following statements by the client indicates a need for further instruction?
A. “I take my other pills at least 30 min after my alendronate.”
B. “I take my alendronate at the same day every week with an 8 ounce glass of milk.”
C. “I sit up and read the morning paper after taking my alendronate.”
D. “I will need to have a bone density test occasionally while taking this medication.”
B. “I take my alendronate at the same day every week with an 8 ounce glass of milk.”
Taking alendronate with milk or other calcium-containing products can decrease its absorption. Therefore, the statement indicating that the client takes alendronate with an 8 ounce glass of milk suggests a need for further instruction.
A nurse is reinforcing teaching for a client who is about to start therapy with alendronate to treat osteoporosis. For which of the following findings should the nurse instruct the client to monitor and report as an adverse effect of the medication? (Select all that apply.)
a. Tinnitus
b. Jaw pain
c. Blurred vision
d. Drowsiness
e. Dysphagia
B. Jaw pain
C. blurred vision
E. Dysphasia
Alendronate effervescent Tablets to treat osteoporosis so patient teaching with that
Should be taken with 8 oz of water in the early morning before eating
Clients using IV preparations should have dental examinations and preventative treatment prior to starting therapy to minimize the risk of osteonecrosis of the jaw.
Risk factors for osteoporosis
Gender
History
Lean Body build
Older than 60
Postmenopausal estrogen defeciency or low levels of calcitonin.
Too much or to low protein intake.
History of smoking and high alcohol intake.
Excess caffeine consumption.
Inadequate calcium and vitamin D intake.
History of gastric bypass.
Lack of physical activity.
A nurse is teaching a group of clients about the risk factors for osteoporosis. Which of the following should the nurse include as a risk factor for osteoporosis?
a. Early menopause
b. history of falls
c. African American race
d. obesity
A. Early menopause
Celecoxib
Analgesics and anti-inflammatories
- used to relieve pain unrelieved by acetaminophen and topical agents, and synovitis (inflammation of tissues that line a joint) if present.
Celecoxib adverse effects
NSAIDs are nephrotoxic and should be taken as prescribed.
Report evidence of black tarry stool, indigestion, and shortness of breath.
Monitor BUN, creatinine, and I&O.
Because the patient is taking celecoxib (Celebrex) for osteoarthritis, he knows to watch for and report which of the following possible indications of an adverse reaction to celecoxib?
Weight gain
A client is about to begin celecoxib therapy for osteoarthritis. You should instruct the client to watch for an report which of the following possible indications of a serious reaction to this drug?
A. black, tarry stools
B. polyuria
C. bone pain
D. dry mouth
A. Black, tarry stools
Early clinical manifestations of osteoarthritis
Join pain and stiffness (resolves at rest)
Limited movement
Crepitus
Deformity
A nurse is completing a physical assessment of a client who has early osteoarthritis. Which of the following manifestations should the nurse expect?
a) Symmetric joints affected
b)Pain worsens with activity
c)Weight loss
d)Ulnar deviation
B. Pain worsens with activity
Osteoarthritis and patient teaching
Joint protection
Balance activity with rest
Healthy weight
Fall prevention
Complementary and alternative therapies
— discuss with health provider first
A nurse is teaching a group of clients about osteoarthritis. Which of the following recommendations should they include in the teaching??
A. Use Echinacea to manage joint pain.
B. Maintain a recommended body weight.
C. Apply ice to the joint before exercising.
D. Reduce the amount of purine in the diet.
B. Maintain a recommended body weight
A nurse in a medical clinic is providing teaching to an older adult client who has osteoarthritis that is affecting her knees. Which of the following client statements indicates an understanding of the teaching?
A: “I can use either heat or ice to help relieve the discomfort.”
B: “Ibuprofen is the first step in medication therapy for osteoarthritis.”
C: “I should limit physical activity to prevent further injury.”
D: “I will elevate my legs by placing two pillows under my knees when I go to bed.”
A: “I can use either heat or ice to help relieve the discomfort.”
A nurse is teaching a client who has osteoarthritis. Which of the following instructions should the nurse include in the teaching?
A: “Apply a heat pack at a temperature below your body temperature.”
B: “Elevate the affected joint on large pillows.”
C: “Take acetaminophen as the primary medication to treat the pain.”
D: “Decrease foods high in purines.”
C: “Take acetaminophen as the primary medication to treat the pain.”
