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Ellie-NUR 120 > Mobility pt 2 > Flashcards

Mobility pt 2 Flashcards

1
Q

what are pt care ergonomics

A

proper body mechanics

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2
Q

what are some proper body mechanics

A

bend w/ knees
carry pt close to body
raise bed
ask for help
lift @ same time
use assisted lifts
feet shoulder width apart
face toward object lifting
lower side-rail
use step stools

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3
Q

what does deconditioned mean

A

loss of physical fitness

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4
Q

what part of the brain is responsible for mobility

A

motor cortex (frontal lobe)

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5
Q

what are some factors affected by immobility

A

musculoskeletal system
cardiovascular system
respiratory system
urinary system
integumentary system
gastrointestinal system
metabolic system
mental health

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6
Q

what are some effects of immobility

A

decreased muscle size
decreased tone and strength
decreased joint mobility and flexibility
bone demineralization
contractures or ankylosis

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7
Q

what is the best way to avoid osetoporosis

A

walking

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8
Q

what is stasis

A

slow

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9
Q

what are the effects of immobility on the cardiovascular system

A

increased cardiac workload
orthostatic hypotension
venous stasis
venous thrombosis

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10
Q

what is venous thrombosis

A

clot

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11
Q

what does venous stasis lead to

A

venous thrombosis

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12
Q

what are some effect of immobility on the respiratory system

A

decreased ventilatory effort (harder to breathe lying down)
increased respiratory secretions
decrease in depth and rate of respirations
poor exchange of carbon dioxide and o2
atelectasis

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13
Q

what is atelectasis

A

incomplete expansion or collapse of lung tissue

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14
Q

what are some effects of immobility on the urinary system

A

increased urinary stasis
increased risk of renal calculi
decreased bladder tone

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15
Q

what does urinary stasis mean

A

urine stays in bladder and can lead to uti

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16
Q

what are renal calculi

A

kidney stones

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17
Q

what does decreased bladder tone lead to

A

incontinence

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18
Q

what are some effect of immobility on integumentary system

A

increased risk of skin breakdown
increased risk of pressure injury

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19
Q

how often are you supposed to turn pt’s

A

every 2 hrs

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20
Q

what are some effects of immobility on gi system

A

disturbance in appetite
altered digestion
altered metabolism of nutrients
decreased peristalsis

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21
Q

what are some effects of immobility on metabolic system

A

increase for electrolyte imbalance
altered exchange if nutrients and gases

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22
Q

what are some effects of immobility on mental health

A

decrease self-concept
decrease social interaction
increase sense of powerlessness
increased risk of depression

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23
Q

what are 2 common disorders of the joints and bones

A

rheumatoid arthritis and osteoporosis

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24
Q

what are some characteristics of rheumatoid arthritis

A

Inflammatory, systemic,
autoimmune
Affects synovial joints primarily
Affects men and women
Results in joint stiffness, pain,
swelling and deformity

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25
Q

what is the goal of treating rheumatoid arthritis

A

decrease pain and inflammation
prevent disabling deformities

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26
Q

what are the 3 main types of drugs to treat RA

A

NSAID’s (nonsteroidal anti-inflammatory drugs)
glucocorticoids
DMARD’s (disease modifying antirheumatic drugs)

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27
Q

what are some characteristics of DMARD’s

A

Immunosuppressive
Decrease joint inflammation
Symptomatic relief
Delay progression
2 types: Non Biologic and Biologic
on the med continuously

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28
Q

what is the prototype of non biologic antimetabolite

A

methotrexate

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29
Q

what class is methotrexate

A

antirheumatic

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30
Q

what is the pharmacologic action of methotrexate

A

immunosuppression

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31
Q

what are the adverse reactions to methotrexate

A

Dizziness
headache
blurred vision
nausea and vomiting
bone marrow suppression
gastrointestinal ulceration and pulmonary fibrosis teratogenic effects

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32
Q

what is pulmonary fibrosis

A

damage on lungs

33
Q

what are the interventions for methotrexate

A

monitor lab values: RBC,WBC & Platelets
Liver Function
abdominal pain
diarrhea
nutritional status
GI bleed
Respiratory distress
jaundice

34
Q

how do you administer methotrexate

A

once a week
orally, subcutaneously, or IM

35
Q

what are some contraindications for methotrexate

A

clients with liver insufficiency
renal insufficiency or alcoholism
pregnancy and breast feeding

36
Q

what are some precautions for methotrexate

A

caution if client has bacterial or viral infection or peptic ulcer disease or
ulcerative colitis

37
Q

what are some interactions of methotrexate

A

Can cause digoxin toxicity
NSAID’s and sulfonamide toxicity
caffeine decreases effectiveness
warfarin increases the risk for bleeding
alcohol ingestion
increases chance of hepatotoxicity

38
Q

what is the prototype of biologic antimetabolite

A

etanercept

39
Q

what class is etanercept

A

antirheumatic

40
Q

what is the pharmacologic action of etanercept

A

inactivation of tumor necrosis factor

41
Q

what are some adverse reactions with etanercept

A

Dizziness
pharyngitis
upper respiratory infections
abdominal pain
psoriasis
pancytopenia
heart failure
reactivation of latent TB or new development of
TB

42
Q

what are some interventions of etanercept

A

Monitor signs of infection
cough
shortness of breath
elevated blood
pressure and heart rate
production of pink sputum
TB test

43
Q

how is etanercept administered

A

once a week subcutaneously

44
Q

what are some contraindications/precautions of etanercept

A

active infection
hematologic disease, or malignancy
autoimmune disorders of the central nervous system such as multiple sclerosis

45
Q

what are some interactions of etanercept

A

Can cause bone marrow suppression when used in clients taking chemotherapeutic drugs
do not give with anakinra
due to increased risk of infection avoid use of live vaccines

46
Q

what are some characteristics of osteoporosis

A

Reduces bone mass
decreases bone density
progressive
women post menopausal @ higher risk
men @ risk as aging- reduction of testosterone, long term glucocorticoid therapy, alc abuse, caffeine, tobacco, and non weight bearing disorders
Results in increased risk for fractures: most
common sites are hip, wrist and spine

47
Q

what does SERM stand for

A

selective estrogen receptor modulators

48
Q

what is the prototype of SERM’s

A

raloxifene

49
Q

what is the class of raloxifene

A

bone absorption inhibitor

50
Q

what is the pharmacologic action of raloxifene

A

activates estrogen receptors decreasing bone loss maintaining bone mineral density

51
Q

what are some adverse reactions with raloxifene

A

increased risk of stroke
pulmonary embolism
deep vein thrombosis
hot flashes
teratogenic

52
Q

what are some interventions for raloxifene

A

Monitor bone density
signs of DVT
PE and cholesterol
hormones and fibrinogen

53
Q

how do you administer raloxifene

A

orally daily w/ or w/out food
take w/ vit D and calcium
perform weight bearing exercises

54
Q

what are some contraindications of raloxifene

A

clients with DVT or history of DVT
pregnancy and breast feeding
elevated serum lipid levels

55
Q

what are some interactions with raloxifene

A

do not take concurrently w/ estrogen

56
Q

what is the prototype of bisphosphonate

A

alendronate

57
Q

what class is alendronate

A

bone absorption inhibitor

58
Q

what is the pharmacologic action of alendronate

A

decrease bone resorption by
inhibiting activity of osteoclasts

59
Q

what are some adverse reactions of alendronate

A

esophagitis
nausea
vomiting
abdominal pain
muscle and joint pain
eye and vision changes

60
Q

what are some interventions for alendronate

A

monitor for decreased bone resorption and
changes in vision
manage muscle and joint pain

61
Q

how do you administer alendronate

A

orally daily w/ glass of water and 30 minutes before other drugs, food, or drinks
pt needs to remain sitting or standing for 30 min after taking drug

62
Q

what are some contraindications of alendronate

A

clients with esophageal strictures or difficulty
swallowing
renal insufficiency
hypocalcemia
upper GI disorders
infections
liver disease
heart failure

63
Q

what are some interactions with alendronate

A

do not take calcium
supplements or dairy products
within 30 minutes of administration

64
Q

what is the prototype of calcitonin

A

calcitonin-salmon

65
Q

what is the class of calcitonin

A

hypocalcemic

66
Q

what is the pharmacologic action of calcitonin

A

decrease bone resorption by
inhibiting activity of osteoclasts and increasing excretion of calcium

67
Q

what are some adverse reactions with calcitonin

A

allergy to salmon or gelatin diluent can
cause anaphylaxis
hypocalcemia
nasal dryness
headaches
epistaxis
nausea and vomiting
polyuria

68
Q

what are some interventions of calcitonin

A

monitor for signs of hypocalcemia such as
muscle spams, tinging of fingers and toes, and low serum calcium levels, allergic reactions and anaphylaxis

69
Q

how do you administer calcitonin

A

intranasal, subcutaneous, or IM
protect from light and refrigerate
encourage high calcium and vit d diet

70
Q

what are some contraindications of calcitonin

A

pt w/ allergies to salmon or other fish protein

71
Q

what are some interactions of calcitonin

A

monitor closely if pt is also taking lithium

72
Q

what is the prototype of calcium supplements

A

calcium citrate and calcium carbonate

73
Q

what is the class of calcium supplements

A

mineral and electrolyte supplements

74
Q

what is the pharmacologic action of calcium supplements

A

non dietary form of calcium

75
Q

what are some adverse reactions to calcium supplements

A

hypercalcemia
nausea and vomiting
constipation
polyuria
depression
renal calculi
hypercalciuria

76
Q

what are some interventions for calcium supplements

A

Monitor serum calcium
decreased gastric and intestinal motility
urine output
flank pain
blood in urine

77
Q

how do you administer calcium supplements

A

orally or IV
give 1 before or 2 hrs after glucocorticoids, thyroid supplements, tetracycline, and quinolone
take w/ glass of water

78
Q

what are some contraindications of calcium supplements

A

clients with hypercalcemia or low phosphate level
kidney stones
cardiac arrythmias

79
Q

what are some interactions with calcium supplements

A

monitor closely if client also
taking digoxin for digoxin toxicity
clients taking a thiazide diuretic are at increased
risk for hypercalcemia
Do not take close to a meal when eating cereals, rhubarb and spinach as it decreases absorption

Ellie-NUR 120 (8 decks)

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