management of pts w/ MS disorders (4) Flashcards
what are causes of low back pain?
-“awkward mvmt”
-trauma/fall
-OA of spine
-OP of vertebrae
-scoliosis
acute back pain lasts shorter than this amt of time, chronic lasts longer than this time
3 months
how does a client with lower back pain present?
-radiculopathy
-sciatica
-sharp/stabbing pain
-sacral and lumbar
diagnostic tests for low back pain
x-ray
CT/MRI
what can not be used for low back pain?
narcotics
what meds are used for chronic lower back pain
TCAs (amitriptyline)
SSRIs (duloxetine)
atypical anticonvulsants (gabapentin)
complications of lower back pain
loss of bowel or bladder function
what should you take for daily back pain?
NSAIDs
what kind of NSAIDs are used for back pain
-ibuprofen/ASA
-ketorolac
-tramadol
what muscle relaxants are used for back pain
cyclobenzaprine
what tricyclic antidepressants / atypical anticonvulsants are sued for back pain
amitriptyline
duloxetine
gabapentin
what opioids are used for back pain?
-hydrocodone/acetaminophen
-oxycodone/acetaminophen
what is needed to absorb calcium?
active vitamin D
what are food sources of calcium?
beans, milk, cheese, yogurt, sardines, oranges
what are food sources of vitamin d
-cheese
-margarine
-butter
-fortified milk
-healthy cereal
-fatty fish
what is happening in osteoporosis?
-reduced bone mass
-deterioration of bone matrix
-diminished architectural strength
-fracture easily under stress
how will a client with osteoporosis present?
-back pain
-loss of height
-stooped posture
-bones fracture easily
-early = no sx
lab tests for osteoporosis
DEXA scan!!
xray, serum P&Ca, ALP, urine Ca, hematocrit
what are foods that can help osteoporosis
cheese, dairy, broccoli, canned salmon
why are biphosphates used to help osteoporosis
slow osteoclasts to decrease bone loss
what are the bisphosphates used for osteoporosis
alendronate!!! (weekly pill)
risedronate, ibandronate, zoledronic acid
what is the antineoplastic used for osteoporosis
denosumab
what estrogens are used for osteoporosis
raloxifene
what is the condition of soft/weak skeletal bones
-commonly in lower back, pelvis, hips, legs, and ribs
Osteomalacia
osteomalacia is a _______issue
vitamin d
what are causes of osteomalacia?
-renal failure
-GI disorder
-hyperparathyroidism
-meds
-lack of vitamin d
-malnutrition
how will a client with osteomalacia present?
-pain/tenderness to bone
-bowing of bones
-possible fractures
-possible pathologic fxs
-waddling gait
-possible steatorrhea
-pain not relieved by rest
labs and tests for osteomalacia
xray, serum Ca/P levels&ALP, urine CA and creatinine
what are complications of osteomalacia
fractures
how can nurses help pts with osteomalacia
-discuss diet
-supplements for liver/kidney issues
-sunlight
-braces
