Exam 3 study guide Flashcards
What does -1.0 T-score an a DEXA scan mean?
normal
DEXA Score below -1.0 is
Abnormal
T-score below -1.0 to -2.5
Indicates osteopenia
T-score on a DEXA scan below -2.5
Indicates osteoporosis
Teaching points about Fosamax
- Take first thing in the morning on an empty stomach. Sit up and nothing to eat or drink for 30 mins. Take with regular tap water.
- If bisophosphate Ibandronate nothing to eat or drink and sit or stand for 60 mins
- Can cause esophogitis, muscle pain, ocular problems
- Do not give to clients who have esophageal disorders and those who cannot sit or stand at least 30 mins after swallowing
Teaching points about calcitonin
- If calcitonin human can only be given SQ
- Calcitonin salmon can be given intranasaly, be sure to inspect each nares before admin and alternate each nare
- Monitor for hypocalcemia
Teaching points about estrogen/estrogen antagonist
- Stop 48-72 hrs before prolonged immobility
- Do not give if hx of DVT
Teaching points about parathyroid hormone/parathyroid hormone angonist
- Linked to causing bone cancer
- Given to clients at a very high risk for fractures
Teaching points about monoclonal activity
- Treats hypercalcemia
- Treats bone cancer and bone problems
Suppluments used for bone health and how they work
- Calcium assists in building strong bones early in life and maintain bone integrity later in life
- Vitamin D assists in the absorption of calcium
Client education for fall precautions
- Remove rugs
- Clearly mark doorways, steps, thresholds
- Clear pathways of clutter
- Provide adequate lighting
- Wear non-slip socks socks when walking in the house
- Properly instruct use of assistive devices
- Exercise regularly: correct body mechanics and proper posture. Stay independent for as long as you can with ADLs
- Review medications: pain relievers, muscle relaxants anti-inflammatory meds, neurological meds, bone support meds
- Yearly eye exams
- Handle bars in bathrooms
- Shower chairs
Dietary teaching for osteoporosis patients
- Vitamin C/D, calcium, protein, iron
- Adequate fluid intake to prevent kidney stones
Normal calcium levels
9-11
Calcium 8 or less
Calcium deficiency and osteoporosis
Normal vitamin D levels
30-50
Vitamin D of 20-30
indicates insufficiency
Vitamin D toxicity level? What can it cause?
above 50
Dehydration
Kidney damage
Hypercalcemia
D/C teaching for a patient with a knee arthroplasty
- Avoid knee gatch and pillows behind the knee
- Place one pillow under the lower calf and foot to cause a slight extension of the knee joint and to prevent flexion contractures.
- Knee can rest flat on bed
- To prevent pressure injury on the heels, place a small blanket or pillow slightly above the ankle area to keep heels off the bed.
- Ice or cold therapy to incisional area to reduce post op swelling
- Kneeling and deep knee bends are limited indefinitely after sx
Risk factors for back pain
- Obesity
- Cigarette smoking
- Occupation
- Poor posture
- Poor physical condition
- Poor sleeping condition
Stress
Nursing diagnosis r/t fibromyalgia
- Ineffective sleep patterns r/t chronic pain
- Chronic pain r/t disease process
- Depressed mood r/t chronic pain
- Ineffective coping r/t chronic pain
Pathophysiology of fibromyalgia
- A disorder of the SOFT connective tissue that causes widespread pain
- Acute episodes can be triggered by infection, stress, physical trauma or stress
- Pain -> Muscle tension -> daily stress -> limited activity -> fatigue -> Depression -> Muscle stiffness
Parkinsons medication that reduces tremors and drooling
Anticholinergics
Parkinsons medication that treats bradykinesia, tremors, and rigidity
Dopamine receptor agonist
or
Carbidopa-levidopa
Nursing interventions for bradykinesia
- Place patient on fall precautions
- Teach patient to take short deliberative steps, with feet somewhat spread