Musculoskeletal Flashcards
How can G.I upset be minimized ?
Get med with food or milk
Because aspirin inhibit prostaglandin what can it eliminate ?
Sodium and water
What is the #1 drug of choice for RA ?
Aspirin - ASA ( Acetylsalicylic Acid )
ASA is considered what kind of drug ? What cranial nerve does it affect ?
Oxotoxic
8th cranial nerve (auditory )
Probenecid may _______ the anticoagulant effect of heparin ?
Increase
So there a risk for bleeding
What do client receiving intra articular injection must be caution to not do what ?
Overly stress the joint
What are dietary supplement that are encourage to prevent osteoporosis ?
Calcium and potassium
What are signs and symptoms of adrenal crisis ?
Hypotension Lethargy Dehydration Weakness Restlessness Nausea , vomiting , diarreah
Stopping corticosteroids abruptly can cause what condition ?
Adrenal crisis
Adrenal insufficiency
To decrease morning stiffness , when is the best time to administer large dose of aspirin ?
Bedtime
Or 1hr before rising
What should you do if a patient have and allergic reaction to aspirin ?
Stop giving immediately and notify the physician
What are some allergic reaction to aspirin ?
Urticaria (hives )
Anaphylaxis
Asthmatic response
When taking aspirin what should the nurse monitor ?
Edema
Excessive weight gain
What are some side effects of aspirin ?
Tinnitus (ringing of the ear )
GI bleeding (pain )
Blood in the stool (tarry stool )
Because aspirin inhibit prostaglandin , what can it eliminate ?
Sodium and water
What is IM intra articular ?
IM injection into the joint
Patient should be instructed to call and report what symptoms of taking corticosteroids ?
Productive cough
Angina
Worsening fatigue
Dyspnea
What are expected findings when glucocorticoid are used for treatment of RA ?
Relief of pain increase energy
What should be restricted for patient taking aspirin ?
Sodium
What are side effects for patient taking aspirin to develop ?
Constipation
Take stool softners
What can patient taking corticosteroids , high dose long term cause ?
Gastric ulceration
For anti inflammatory effectiveness is aspirin and acetaminophen interchangeable ?
No
How do you know aspirin is out of date ?
Decompose in humidity
Smell like vinegar
Patients taking corticosteroids bruise easily and cause what to increase
The fragility of capillaries
Take vitamin c to decrease bruising
It is most important for the nurse to assess which s/e if a patient is talking flutocorsone for Addison’s disease ?
Potassium depletion
When children are on prolonged glucocorticoid therapy , what is important it monitor ?
Skeletal growth
Patient recieving long term corticosteroids are at high risk for development of what visual disturbance ?
-Cataract (it interfere with protine reaction )
What can you teach a patient about corticosteroids ?
Cataract formation
Bruise easily
Affect metabolism
What happens when taking corticosteroids by mouth (po) ?
It suppresses and decrease production of protective mucus and increase HCL
What are side effect of corticosteroids ?
Hypocalcemia Hypernatremia HTN Buffalo hump Adrenal sufficiency Fluid retention
What is the most common type of corticosteroids /dose ?
Medrol dose pack 4mg tabs
Clients recieving long term corticosteroids therapy should be tough to carry what with them ?
Carry identification
Patient recieving prednisone should be thought that it ?
Must be tapered to be discontinue
What is a cox 2 inhibitor ?
Celebrex (celecoxib )
S/E- GI distress
Take w/food
NSAIDs are generally contraindicated in patients with ?
Allergy to aspirin
The nurse understand that and inflammatory response is
A normal body response to trauma or tissue injury
- characterized by vasodilation
- last 10-15 mins after injury occurred
The treatment of choice for gouty arthritis is ?
Colchicine
The nurse monitor the patient taking salicylate a for what potentially life threatening response ?
Hypersensitivity
What effects do corticosteroids have on blood glucose levels
Hyperglycemia
Patient taking aldoctone (k+ sparing diuretic ) should be on what kind if diet ?
Potassium restrict diet
Methopredisone (lupus med ) should be administered at what time of the day ?
Early morning
8am preferred
Allopurinol and probenecid are proscribed to treat gout because of their action as ?
Uricosuric agent
The priority nursing diagnosis for client experiencing gout is ?
Acute pain related to uric crystal deposit
A client prescribed probenecid(benemid ) , allopurinol (zyloprim ) , anturane (sulfinpyrazone) should be instructed to do what ?
Increase fluid intake
3000 cc a day
When teaching a client with gout factors that may provoke attack , the nurse should include ?
High fat diet & thiazides diuretic
What nonsteriodial anti- inflammatory agents are long term use for arthritis ?
Celebrex , aspirin
What can adrenal crisis causes ?
Severe hypotension
Muscle weakness
If plain aspirin cannot be tolerated what can be given ?
- Ecotrin (enteric coated ) /may have a delayed therapeutic effect
- Or buffered aspirin
A client taking corticosteroids who experience development of hypotension , weakness , nausea , vomiting , lethargy and headache should be monitored for impending ?
Adrenal crisis
Administer corticosteroids early in the day to avoid ?
Insomia
Benemid (probenecid)
Avoid aspirin
Administer w food
Colchicine
Drug of choice in acute attack
Zyloprem
Decrease production of uric acid
What if you giving a patient medication and they said they already had it , what do you do ?
Check the MAR
If a patient has pain and put the call light in what is your next step ?
Do a pain assessment
If you have a elderly client that just came out of surgery and you have 2 different order of med 10mg and 15mg , which do you give first ?
For elderly start at the lower dose first
Demerol
Cns depressant
Respiration concern
What is nepasin (NSAID )
Muscle relaxer
If patient in on Coumadin or heparin and is givin aspirin , what caution needs to be taken ?
Bleeding
Why do doctors sometimes prescribe cortisone therapy every other day ? Gyal
Minimize/decrease the supression of normal adrenal activity
