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Health and Healing II - Older Adults > Bone and Joint Health > Flashcards

Bone and Joint Health Flashcards

1
Q

What does the Musculoskeletal System Do?

A
  • Allows us to be upright

- Carry out ADL’s

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2
Q

What must a gerontological nurse be aware of?

A
  • Attends to needs of older persons with musculoskeletal problems
  • Works to promote healthy bones and joints
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3
Q

What is Osteoporosis?

A

“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
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4
Q

Primary vs Secondary Osteoporosis

A
  • Primary

- Secondary is caused by another disease state, medications (paget’s disease or long-term steroid use)

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5
Q

Non-modifiable risk factors for Osteoporosis

A
  • Female gender
  • White race
  • Northern European ancestry
  • Advanced age
  • Family history
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6
Q

Modifiable risk factors for Osteoporosis

A
  • Underweight
  • Low ca intake
  • Estrogen deficiency
  • Low T
  • Inadequate activity
  • Steroid use/anticonvulsants
  • Excess coffee, alcohol
  • Cigarette smoking
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7
Q

Reducing Osteoporosis-related risk and injury

A
  • Exercise (weight bearing maintains bone mass)
  • Nutrition
  • Lifestyle changes
  • Fall prevention
  • Body mechanics
  • Home safety
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8
Q

Pharmacological Interventions

A
  • Adequate Ca and Vitamin D
  • Combo: Calcitrate-D
  • Bisphosphonates
  • Selective estrogen receptor modulators (SERMs)
  • Parathyroid hormone
    Calcitonin
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9
Q

Recommended supplemental vitamin D

A

800-2000 IU

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10
Q

Example of Calcitonin

A

Miacalcin

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11
Q

Bisphosphonates

A

Fosamax, Actonel, Boniva

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12
Q

Parathyroid Hormone

A

Teriparatide (forteo)

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13
Q

Arthritis

A
  • 100+ diseases

- #1 reason for activity limitations in middle age onward

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14
Q

Most common forms of Arthritis

A
  • Osteoarthritis
  • Polymyalgia rheumatic
  • Rheumatoid arthritis
  • Gout
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15
Q

Risk Factors for Osteoarthritis

A
  • Increased age
  • Obesity
  • Family history
  • Repetitive use/trauma
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16
Q

What is Osteoarthritis?

A
  • Degenerative joint disease
  • Normal soft and resilient cartilaginous lining becomes thin and damaged
  • Joint space narrows, bones rub
17
Q

Can Osteoarthritis be cured?

A
  • Only joint replacement
18
Q

Polymyalgia Rheumatica (PMR)

A
  • More common inflammatory disease in older persons
  • Stiffness, especially in the morning <1 hr
  • Symptoms may be quickly relieved by small doses of corticosteroids
19
Q

Rheumatoid Arthritis

A
  • Persistent, systemic inflammatory joint disorder
  • Autoimmune disease
  • Products from inflamed lining of the joint invade and destroy the cartilage and bone within the joint
20
Q

Symptoms of RA

A
  • Pain and swelling in multiple joints in a symmetrical pattern
  • fatigue and malaise
    Occasional fevers
21
Q

Treatment for RA

A
  • Treat with disease-modifying anti-rheumatic drugs
  • Monitor progression
    Provide comfort and support
  • Monitor effectiveness of treatment
22
Q

Gout

A
  • 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
23
Q

Gout symptoms

A

Pain in affected joint, joint is bright, purple-red, hot, too painful to touch

24
Q

Gout risk Factors

A
  • High blood pressure
  • Diet high in purines
  • Medications
25
Q

Gout Treatment

A
  • Avoidance of medications/foods high in purines or alcohol
  • Allopurinol/colchicine (decrease uric acid production)
  • Probenecid (increases excretion of uric acid)
  • Increase fluids to help flush (2L/day if not contraindicated)
26
Q

Assessment

A
  • Examine joints for tenderness, swelling, warmth, redness
  • Examine hands for presence/absence of osteophytes
  • Evaluate passive/active ROM
  • Test flexibility of hands
27
Q

Interventions

A
  • Adequate/prompt treatment
  • Pain control
  • Medication administration
  • Evaluation
  • pt. teaching
  • Surgical replacement of the joint (arthroplasty)
28
Q

Complementary/Alternative Interventions for OA

A
  • Glucosamine; chondroitin
  • Acupunture
  • Massage

Health and Healing II - Older Adults (17 decks)

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