Musculoskeletal Flashcards
Osteoprosis
a) risk factor
b) manifestations
a) Menopause
age>65
female
low physical activity
low weight
smoking alcohol
b) vertebral fractures
loss of hight
Kyphosis
back pain
Diagnostic
a) gold standard
b) T-score
a) DEXA (Dual-Energy X-ray Absorptiometry)
b) +1&-1= normal
-1 to -2.5=osteopenia
<-2.5 osteoporosis
<-2.5 w/fragility fractures=sever
Nursing care
a) Ca intake?
b) exercise
a) Woman
less than 50yr 1000mg. older than 51yr 1200mg
Men
less than 71 yr 1000mg,older than 71yr 1200mg
b) Regular exercise with muscle strength
weight-bearing training
avoid high impact activity
Nursing care
a) drug therapy
b) side effects
a) Ca supplement(take with meal)
Bisphosphonates
Risedronate
Zoledronic acid
b) anorexia
wt loss
gastritis
The nurse is taking the history of an adult female client. Which factor places the client at risk for osteoporosis?
a) Consuming 12 ounces of carbonated beverages daily
b) Working at a desk and playing the piano for a hobby
c) Having a hysterectomy and taking estrogen replacement therapy
d) Consuming one alcoholic drink per week
b
Gout
a) patho
b) cause
a) hyperuricemia (inc uric acid) and uric acid crystals to be deposited in the joints
b) The kidney can’t excrete enough uric acid
heredity 遺伝
medication, alcoholism
Gout s/s
a) acute
b) chronic
c) Diagnostics
a) swelling, severe pain
joint appears dusky, cyanotic
2-10 days acute episode then the s/s subside
b) Tophi(inflammation)
affect multiple joints
c) Serum ruric >6
synovial fluid aspiration
Gout
Nursing management
What is the low purine food?
*May prevent gouty attacks
*water
*cherries
*low-fat dairy product
*Coffee
vegies,tomato
cereal, eggs,chocolate
Encourage weight loss
Gout
Nursing management
a) Nutrietion?
b) serum acid levels?
c) Xanthine oxidase inhibitor ADR?
a) Avoid alcohol and ketosis diets
Lots of fluid should take
b) keep <6
c) first choice
contra renal failure
look at live r enzyme
Systemic lupus
a) patho
b) prevalence
a) Chronic inflammatory autoimmune disorder
b) 15-44 yr female
influenced by?
genetics
hormones
environment
-sun
-stress
-chemical
-med
Procainamide, hydralazine, penicillamine
manifestations?
ESRD:leading cause of SLE death
Neuro: Problems thinking, seizures, stroke
arthritis 95% 関節炎
butterfly rash 55-85%
Alopecia
Joint pain
skin
Medication
Hydroxychloroquine
a) Motitor?
b) What exam do they need?
a) CBC lab
Kidney/liver function
b) platelet drop=retinopathy
need eye exam every 6 months+before starts
a) Nutrition?
b) Avoid?
c) Vaccine
a) inc caloric intake(infection)
they may low vitamin D(less sun exposure)
b) Sun, have sunscreen!!
Smoking
Stress
Drying soaps
household chemicals
c) Flu+pneumococcal are OK
DO NOT give live vaccine
A nurse is assessing a client who has systemic lupus erythematosus (SLE). Which of the following findings is the highest priority for the nurse to report to the provider?
A)Client report of feelings of depression.
B)Dry, raised rash on the face.
C)Presence of peripheral edema.
D)Joint pain in hands and knees.
C
The client who has SLE is at greatest risk for death from lupus nephritis. Therefore, according to the safety and risk reduction priority setting framework, findings that indicate an impairment of renal function are the highest priority to report.
a,b,d are common
OA
Manifestations
Localize joint pain
NOT systemic (no fever)
One joint at a time
Morning stiffness for 30 mins
cold to touch
asymmetrical
hear or feel crepitation
Valgus deformities, and Herberden’s and Bouchard’s Nodes
EXAM
Post ope
Prevent dislocation
Prevent flexion >90
Do not cross the legs
Elevated toilet seat
Roll the pillow between the legs on the unaffected side
