Bone and Joint Health Flashcards
What does the Musculoskeletal System Do?
- Allows us to be upright
- Carry out ADL’s
What must a gerontological nurse be aware of?
- Attends to needs of older persons with musculoskeletal problems
- Works to promote healthy bones and joints
What is Osteoporosis?
“Porous Bones”
- Low bone mineral density (BMD)
- Diagnosed through DEXA scan, presumed in adults with non-traumatic fractures, loss of >7.5 cm in height, or kyphosis
Primary vs Secondary Osteoporosis
- Primary
- Secondary is caused by another disease state, medications (paget’s disease or long-term steroid use)
Non-modifiable risk factors for Osteoporosis
- Female gender
- White race
- Northern European ancestry
- Advanced age
- Family history
Modifiable risk factors for Osteoporosis
- Underweight
- Low ca intake
- Estrogen deficiency
- Low T
- Inadequate activity
- Steroid use/anticonvulsants
- Excess coffee, alcohol
- Cigarette smoking
Reducing Osteoporosis-related risk and injury
- Exercise (weight bearing maintains bone mass)
- Nutrition
- Lifestyle changes
- Fall prevention
- Body mechanics
- Home safety
Pharmacological Interventions
- Adequate Ca and Vitamin D
- Combo: Calcitrate-D
- Bisphosphonates
- Selective estrogen receptor modulators (SERMs)
- Parathyroid hormone
Calcitonin
Recommended supplemental vitamin D
800-2000 IU
Example of Calcitonin
Miacalcin
Bisphosphonates
Fosamax, Actonel, Boniva
Parathyroid Hormone
Teriparatide (forteo)
Arthritis
- 100+ diseases
- #1 reason for activity limitations in middle age onward
Most common forms of Arthritis
- Osteoarthritis
- Polymyalgia rheumatic
- Rheumatoid arthritis
- Gout
Risk Factors for Osteoarthritis
- Increased age
- Obesity
- Family history
- Repetitive use/trauma
What is Osteoarthritis?
- Degenerative joint disease
- Normal soft and resilient cartilaginous lining becomes thin and damaged
- Joint space narrows, bones rub
Can Osteoarthritis be cured?
- Only joint replacement
Polymyalgia Rheumatica (PMR)
- More common inflammatory disease in older persons
- Stiffness, especially in the morning <1 hr
- Symptoms may be quickly relieved by small doses of corticosteroids
Rheumatoid Arthritis
- Persistent, systemic inflammatory joint disorder
- Autoimmune disease
- Products from inflamed lining of the joint invade and destroy the cartilage and bone within the joint
Symptoms of RA
- Pain and swelling in multiple joints in a symmetrical pattern
- fatigue and malaise
Occasional fevers
Treatment for RA
- Treat with disease-modifying anti-rheumatic drugs
- Monitor progression
Provide comfort and support - Monitor effectiveness of treatment
Gout
- Results from the accumulation of uric acid crystals in a joint
- May be acute, or chronic with acute attacks
- Proximal joint of toe is most common
Gout symptoms
Pain in affected joint, joint is bright, purple-red, hot, too painful to touch
Gout risk Factors
- High blood pressure
- Diet high in purines
- Medications
