Exam 2 - chronic illness part 2 Flashcards
what is the most serious complication of GERD?
aspiration pneumonia
what are modifiable risk factors of osteoporosis?
- underweight
- low calcium intake
- low estrogen
- low testosterone
- inadequate exercise
- steroids & anticonvulsants
- excess coffee & EtOH
- smoking
why does menopause accelerate osteoporosis in women?
estrogen deficiency
at what age do women need to be screened for osteoporosis?
≥ 65
what are the diagnostic tests for osteoporosis?
- DEXA scan
- T-score
T-score parameters for osteopenia
-1 to -2.5
T-score parameters for osteoporosis
> -2.5
what are the nursing interventions for osteoporosis?
- weight training
- adequate Calcium & Vitamin D
- fall preventions
- administering Bisphosphonates (Fosamax)
what is the teaching for Bisphosphonate medications?
- take in the AM
- 30 minutes before breakfast
- take with full glass of water
what are some side effects of Bisphosphonates?
- hypokalemia
- abdominal pain
- musculoskeletal pain
- NV
- gas
what is a common symptom of osteoarthritis?
pain with activity, relief with rest
what are the deformities associated with osteoarthiritis?
- Heberden’s node
- Bouchard’s node
in which conditions is Bouchard’s node present?
- Rheumatoid Arthritis
- Osteoarthritis
what are the interventions for osteoarthiritis?
- weight loss
- enhance strength & flexibility
- hot / cold therapy
- adaptive devices
what are examples of adaptive devices for OA?
- cane
- shoe lift
- knee brace
what are the medications for OA?
- acetaminophen
- NSAID
- steroids (reduce inflammation)
- hyaluronic acid (joint lubrication)
what are the interventions for RA?
- pain management
- administer Methotrexate (DMARD)
RA does not have Heberden’s nodes
true
what are the surgical interventions for OA?
- arthroscopy
- total joint replacement
what are the benefits of surgical interventions for OA?
reduces intractable pain & restores all or some joint function
what are the causes of hyperthyroidism?
- toxic goiter
- Grave’s disease
which gender is most likely to develop hyperthyroidism?
female
which tests assess thyroid function?
- thyrotropin-releasing hormone stimulation test
- thyroid scan
- radioactive iodine uptake
what substances should be avoided before testing thyroid function?
- hormones
- steroids
- foods with iodine
how does hyperthyroidism present in older adults?
- tachycardia
- tremors
- weight loss
what are the types of medications for hyperthyroidism?
- anti-thyroid agents
- iodides
- beta blockers
- radioactive iodine
what is the MOA of anti-thyroid agents?
blocks thyroid hormone production
examples of anti-thyroid agents
- Methimazole
- Propylthiouracil
what is the MOA of iodides?
inhibits thyroid hormone secretion
which iodide is indicated for a thyroid storm?
Saturated Solution of Potassium Iodide (SSKI)
what is the MOA of radioactive iodine?
shinks & destroys thyroid gland
what are the interventions for thyrotoxicosis?
- regulate temperature with ice
- lower the levels of TH
- replace fluid & electrolytes
- stabilize cardiac function
which medication is contraindicated with thyroid storm?
aspirin
how does hypothyroidism manifest in older adults?
- slowed mentation
- gait disturbances
- fatigue
- weakness
- cold intolerance
nursing care for patients with hypothyroidism
- prevent chilling, constipation, skin breakdown, infection
- assess for edema & tachycardia
- lifelong treatment of levothyroxine
what is the major complication of hypothyroidism?
myxedema coma
levothyroxine can cause digoxin toxicity
true
what are the manifestations of myxedema coma?
- hypothermia
- depression / unconsciousness
- hypoventilation
- hypotension
- bradycardia
low temp, mood, RR, BP, HR
how can the nurse treat myxedema coma?
- stabilize vitals
- slow thyroid hormone replacement
how is prostate cancer detected?
screening
what is the most common cancer in men (not related to skin)?
prostate cancer
how does PC manifest?
- urinary retention
- hematuria
- back pain
- cachexia
- bone tenderness
- lower lymphedema
- adenopathy
what are the screening methods for PC?
- digital rectal exam
- prostate-specific antigen
- biopsy
at what age is PC screening recommended?
55 - 69 years old
which group of men has the highest likelihood of developing PC?
African-Americans
the risk for PC increases as PSA results increase
true
there is a 50% chance of developing PC with which level of PSA?
10ng/mL
what are the nursing considerations for anti-thyroid agents?
- report any swelling in lymph nodes
- assess thyroid function tests
- give at same time each day
- give with food
- monitor INR
why are fall preventions in place for older adults with osteoporosis?
prevent hip fractures
what is cogwheel rigidity?
- small jerking movements
- muscle rigidity
this is a movement disorder that involves being frozen
akinesia
what are the manifestations of bradykinesia & dyskinesia?
- difficulty starting, continuing, or coordinating movements
- shuffling
- akinesia
what are resting or non-intention tremors?
- purposeless tremors that disappear with sleep
- pill-rolling
- small handwriting
- monotone voice
