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Nursing School > 🏥- Bone Test > Flashcards

🏥- Bone Test Flashcards

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0
Q

Osteoclasts

A

Cells that help demineralize and destroy old bone

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1
Q

Osteoblasts

A

Cells that help form bone

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2
Q

Estrogen

A

Stimulates osteoblasts activity

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3
Q

Arthrogram

A

A series of images taken of a joint after contrast medium has been injected

Allows for visualization of soft tissue structures of a joint

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4
Q

Dexa scan

A

Assess bone density or the amount of calcium and other minerals in the bone

Bones most often used: spine, hip, hand, foot and forearm

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5
Q

Low bone density is an indicator for what

A

Presence of osteoporosis and increased fracture risk

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6
Q

Osteoporosis

A

Chronic condition that results in deterioration of bone tissue and density

Bone resorption (osteoclasts) exceeds bone formation (osteoblasts)

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7
Q

Primary risk factors for osteoporosis

A 
Age
Gender (female) 
Race (whites and asians) 
Family hx 
Small body frame (less than 58kg) 
Low Ca and vitamin D intake 
High K intake 
Sedentary lifestyle 
Smoking 
Excessive alcohol consumption
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8
Q

Secondary risk factors for osteoporosis

A
  • medications (corticosteroids for more than 3 months, antiepileptics, heparin, thyroid hormones)
  • disease (hypogonadism or early menopause, malabsorption issues, chronic liver disease, ibs, ra, hyper thyroid and parathyroid, previous fracture)
  • other (family hx of hip fracture, recurrent falls, prolonged immobilization)
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9
Q

What is the gold standard for diagnosing and follow up with osteoporosis

A

Dexa scan

Gives precise measurements that highlights areas for future fracture risks

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10
Q

Treatment of osteoporosis

A

Prevention
Muscle-strengthening exercise
Healthy lifestyle

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11
Q

Foods high in vitamin d

A

Vitamin d fortified milk, cereals, egg yolks, saltwater fish and liver

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12
Q

How do bisphosphonates work

A

Impede bone resorption by inhibiting osteoclasts activity, thereby absorbing Ca phosphate in bone

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13
Q

What is teaching that should be done with all bisphosphonates

A

Take in the morning on an empty stomach

Can cause: gi disturbances, dysphagia and inflammation of esophagus

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14
Q

Clinical manifestations of osteoporosis

A 
Dowagers hump 
Loss of height 
Back pain 
Restricting movement 
Previous fractures
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15
Q

Paget’s disease of the bone

A

Bone metabolism disorder associated with accelerated bone remodeling, resulting in bone that is structurally abnormal

bone excessively broken down and reformed

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16
Q

Type of patient most at risk for developing paget’s

A

15-40% linked to genetics

Over age 50
White
Males

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17
Q

Clinical manifestations of paget’s

A

Pain and deformity

Also fractures, bone tumors, neuro diseases, cardiac disease and Ca/Phos imbalance

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18
Q

Types of medications used to treat PDB

A

Analgesics
Calcitonin
Bisphosphonates (decrease osteoclast activity, which suppresses bone resorption)

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19
Q

What is the most serious complication of PDB

A

Development of primary bone tumors , osteosarcoma

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20
Q

Surgical treatment of PDB

A

Joint replacement

Spinal decompression and stabilization

Osteotomy

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21
Q

Varus vs valgus

A

Varus- bowleg knee

Valgus- knock knee

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22
Q

Surgical spinal decompression/spinal stabilization

A

Decompression- removal of bony substances that are causing nerve impingement

Stabilization- surgically inserted rods, pins and pedicle screws that maintain spinal column structure

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23
Q

Nursing diagnoses associated with PDB

A

Risk for trauma

Acute/chronic pain

Impaired mobility

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24
Q

Clinical manifestations of acute osteomyelitis

A
  • fever
  • swelling and tenderness at affected site
  • erythema and heat
  • pain (not relieved by rest)
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25
Q

Clinical manifestations of chronic osteomyelitis

A
  • swelling, tenderness

- constant pain

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26
Q

Which test is the gold standard for diagnosis of osteomyelitis

A

Bone biopsy

27
Q

Which test is the test of choice for detecting osteomyelitis

A

Bone scan

28
Q

ESR and CRP indicate what

A

Inflammation

29
Q

Which lab tests assist in osteomyelitis diagnosis

A

WBC , ESR, blood cultures, CRP

30
Q

What medications are used to treat osteomyelitis

A

Antibiotics, opioids

Fluoroquinolones have been shown to be highly successful because of their bone-penetrating ability

31
Q

Complications of osteomyelitis

A

Sepsis

Squamous cell carcinoma

32
Q

Assessment of osteomyelitis

A

Fever , pain , tenderness , lethargy , difficulty moving or bearing weight at affected area

33
Q

What are the 6 P’s of neurovascular assessment

A 
Pain 
Weak pulses 
Paresthesia (tingling or prickling) 
Paralysis 
Pallor 
Pressure
34
Q

What is the leading clinical indication of TJR

A

Osteoarthritis

35
Q

Complications of TJR

A

Hypotension, bleeding and hypovolemia

Infection
Dislocation/subluxation
DVT
PE

36
Q

Osteosarcoma

A

Is the most prevalent malignant tumor

37
Q

There is a link between osteosarcoma and which disease

A

Paget’s

38
Q

Clinical manifestations of osteosarcoma

A

Pain worse with motion

UNRELIEVED by rest

Decreased range of motion

Swelling

Redness

39
Q

Eating a diet highly in protein helps with what

A

Tissue and wound healing

40
Q

Complete fracture

A

The disruption spans across the width of the bone, causing bone fragments

41
Q

Incomplete fracture

A

The disruption occurs through part of the bone cortex; however there is no displacement of bone fragments

42
Q

Closed (simple)

A

Fracture is contained within the skin

43
Q

Open (compound)

A

Disruption in which pieces of bone protrude through the skin

44
Q

Avulsion fracture

A

Caused by overstretching and tearing of a tendon or ligament, separating a small segment of bone at the insertion site

45
Q

Comminuted fracture

A

Fracture that has several disruptions producing shattered bone segments within the fracture site

46
Q

Compression fracture

A

Fracture caused by excess force along the axis of cancellous (spongy internal layer of bone) bone leading to the bone collapsing on itself; representative in vertebral compression fractures from falls of significant heights

47
Q

Depressed fracture

A

Disruptions in which fragments of bone are forced inward; frequently seen in facial or skull fractures involving blunt trauma

48
Q

Displaced fracture

A

Malalignment of bone fragments at the fracture site

49
Q

Greenstick fracture

A

An incomplete disruption where one side of the bone is bent and the other is fractured; generally seen in children because of the flexibility of their bones

50
Q

Nondisplaced fracture

A

Bone fragments are well approximated within the site of the disruption

51
Q

Oblique fracture

A

The fracture line occurs usually at a 45-degree angle across the cortex of the bone

52
Q

Spiral fracture

A

The fracture wraps around the shaft of the bone

53
Q

Impacted fracture

A

Segments of bone are wedged into each other at the fracture line

54
Q

Nonsurgical management of a fracture

A

Closed reduction

Fractured bone segments are manually manipulated and realigned while the patient is under general anesthesia

55
Q

Open reduction

A

Requires a surgical incision that enables the surgeon to accurately visualize the wound and ensure proper realignment

56
Q

Skeletal traction

A

Pins, tongs, screws and wires are surgically secured to the bone and weight is then applied to provide realignment

57
Q

Skin traction

A

Utilizes a flexible harness, boot or belt to secure the extremity while 5 yo 10lb of weight is applied to relieve muscle spasms

58
Q

Antacids

A

Increase gastric pH

Ex: maalox, mylanta

59
Q

Histamine receptor antagonist

A

Decrease gastric acid production

Ex: Zantac , Pepcid

60
Q

Proton pump inhibitors

A

Block production of acid

Ex: Prilosec, Prevacid, protonix, nexium

61
Q

Mucosal barrier fortifier

A

Ex: sucralfate

62
Q

Education for antacid administration

A
  • may delay absorption of other meds
  • take 1 hour BEFORE or 2 hours AFTER a meal
  • avoid taking with milk or foods high in vitamin d

Ex: maalox and mylanta

63
Q

Education for H2 blockers administration

A
  • administer at bedtime
  • reduce dose for elderly (less gastric secretions)

Ex: Zantac , Pepcid

64
Q

Education for mucosal barrier fortifiers administration

A
  • give 1 hour BEFORE or 2 hours AFTER meals and at bedtime
  • wait 30mins AFTER antacids
  • no aspirin while on med
  • may cause darker stools

Ex: sucralfate

65
Q

Education for PPI’s administration

A
  • give 30mins BEFORE meals
  • do NOT crush capsules
  • assess hepatic function

Ex: protonix, nexium, Prilosec, Prevacid

66
Q

Education for antimicrobial administration

A
  • take with food or immediately after eating
  • avoid alcohol

Ex: flagyl, amoxil

Nursing School (36 decks)

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