chapter32 part 8 Flashcards
older adults w/ decrease creatine should not take
allopurinol
what type of therapy is good for pt that have hypertension and grout
losartan promotes urate excretion
make the person more susceptible to fracture because of the decrease in mass
osteoporosis
low bone mass
osteopenia
what are some risk factors of osteoporosis
age,
chronic disease (i.e., liver, lung, kidney)
medications (i.e., steroids, anticonvulsants, anticoagulants, proton pump inhibitors, selective serotonin inhibitors)
long-term calcium deficiency
vitamin D deficiency,
smoking,
excessive caffeine or alcohol intake,
and sedentary lifestyle
eating disorder and inflammatory bowel disease can lead to
osteoporosis
s/s of osteoporosis
what happen once the pt develops osteoporosis
it is a silent disease
No early signs and symptoms
Height loss, kyphosis, and compression of the spine
when is osteoporosis more commonly Dx
after the pt sustained a fracture from little or no known trauma
how is osteoporosis Dx
Bone radiographs
Dual energy x-ray absorptiometry (DXA or DEXA); reported as a T score
T score os greater than 1 standard deviation from a healthy young adult
normal bone density
T score of -2.5 or more indicate
osteopenia
T score below -2.5 indicates
osteoporosis
what are the goal for osteoporosis
is aimed to stop loss of bone density
Increase bone formation.
Prevent fractures.
what are some other treatment for osteoporosis
Estrogen replacement therapy
Adequate dietary and
supplemental calcium and vitamin D & K
Weight-bearing exercise
Bisphosphonates
Parathyroid hormones
what medication is recommended for pt w/ osteoporosis for 5 year
Bisphosphonates aldendronate
risedronate
zoledronic
RANKL
what is used for pt w prostate cancer
intravenous zoledronic acid
or
denosumab
what type of compression are common in pt w/ osteoporosis
Vertebral compression
involves the percutaneous injection of polymethyl methacrylate (PMMA) a bone cement directly into an osteoporotic spinal area under fluroscopy
vertebroplasty
what type of plasty stabilize the bone snd help reduce or eliminate pain
Vertebroplasty
consist of the percutaneous insertion of an inflatable device into the fracture vertebral body under fluoroscopy
Kyphoplasty
how is Kyphoplasty done
the device is inflated
elevating the end plate and restoring the vertebral toward its original ht
what are some nursing management for osteoporosis
Promote screening for osteoporosis.
Teach the benefits of healthy lifestyle
need for calcium supplement, and weight-bearing exercise.
Medications, cautions, and
side effects
* Upright position for 1 hour after taking bisphosphonate-type drugs to prevent esophageal irritation and erosion
what should you be caution while taking bisphosphonate drug
jawbone necrosis
increase risk for femur
esophageal irritation if the pt does not remain an upright position for an 1 hour
this drug should be stop after 5 years
is a problem of abnormal bone resorption followed by replacement of normal marrow w/ fibrous connective tissue
paget’s diseases (abnormal weak bone)
is there known cause for Paget disease
no
when is the paget disease found
at the time of the fracture occurs
when radiograph reveal abnormality of bone
how is Paget disease Dx
Radiography
24-hour urine collection for pyridineine Collagen
Serum alkaline phosphatase
what are some s/s of PAGET disease
pain
elevated Serum alkaline phosphatase
what is given w/ paget disease to slow down bone resorption
miacalcin
bisphosphonate
what are some nursing management for paget disease
Firm mattress
Light brace or corset
Avoid lifting and twisting
is subject to both benign and malignant tumor
bone tumor
where/ when are benign tumor found
on radiograph or at the time of fracture
malignant tumor can be either
primary and secondary tumor
what age group is malignant most common among
10 to 25 yrs. of age
what is the most common type of malignant
osteosarcoma and
osteogenic sarcoma
osteosarcoma may occur in men older than
60 years
what are some other type of primary malignant tumor
ewing sarcoma
chondrosarcoma
fibrosarcoma
what are some s/s of bone tumor
Pain, warmth, and swelling
how is bone tumor Dx
Radiography
,
bone scan,
biopsy
physical examination
what are some treatment for bone tumor
Surgery, radiation, and chemotherapy
when is chemotherapy given
10 weeks before surgery
chemotherapeutic agents is used depending on ?
what is give to treat hypercalcemia Associated w/ bone tumor
tumor size
location
and health care provider
zoledronic acid
