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NURS310- exam 3
Question | Answer |
---|---|
how often the entire skeleton is remodeled | every 5 years |
osteocytes | preform bone matrix maintainence |
osteoblasts | form new bone |
osteoclasts | resorption of old bone |
osteoporosis | skeletal disease causing low bone mass and deterioration of bone tissue |
# of people affected by osteporosis in the US | 28 million |
osteoporosis is responsible for this many fractures yearly | 1.5million |
lesser known risk factors for osteoporosis | use of corticosteriods & anticonvulsants, dementia, Cushing's syndrome |
diagnosis of osteoporosis | bone mineral density test- measured in spine hip or wrist |
peripheral densitometers | heel/finger |
prevention of osteoporosis | calcium, vit C, exercise, prevention of falls, gain weight, stop smoking |
daily value needed of calcium | 1000-1500mg daily |
side effects of calcium supplements | constipation/gas |
daily needed value of vit D | 400-800IU or 15-20min in the sun daily |
vit D role | calcium absorption and bone metabolism |
sources of vit D | liver, fish oil, milk, calcitrol |
medications ofr osteoporosis | ERT, Fosamax, Evista, Risedronate, Calcitonin |
Paget's Disease | abnormal formation of bone tissue that results in weakened and deformed bones; chronic accelerated bone remoldeling |
sx of Paget's Disease | localized pain, flushing, warmth of the overlying skin |
cause of Pagets Disease | unknown; may be caused by a virus |
Tx of Paget's Disease | surgery-replacement of hip or knee |
medical tx of paget's disease | biphosphonates: Fosamax, Aredia, Skelid; NSAIDS; Celebrex, Vioxx; Calcitonin |
Osteoarthritis | DJD characterized by degeneration and loss of articular cartilage in synovial joints |
most common arthritic disorder | osteoarthritis |
leading cause of disability in the aged | osteoarthrits |
osteoarthritis affects this many americans | 20-40million |
risk factors for osteoarthrtis | obesity, muscle weakness, nerve injury, oversuse, aging, genetics, women |
manifestations of osteoarthrtis | gradual inset with slow progression, stiffness after periods of immobility, crepitus, Herberden's (DIP) & Bouchard's (PIP) nodes, localized pain relieved by rest |
diagnosis of osteoarthritis | H&P and X-ray |
mngmnt of osteoarthritis | stretching, exericse, wgt control, ROM |
medication for osteoarthritis | analgesics( Tylenol, Darvon) NSAIDS (ASA, ibuprofen) Hyaluronic Acid Therapy COX-2 ( Celebrex, Vioxx) |
surgeries for osteoarthritis | arthroscopy & arthroplasty |
Rheumatiod Arthritis | autoimmune connective tissue disease that most commonly causes inflammation of the joints and joint deformity; antibodies destroy own body tissues; bilateral; chronic illness |
ppl affected by RA | 1% of population; more women/ages 30-50yrs |
cause of RA | unknown |
manifestation of RA | fever, weakness, anorexia, weight loss, sching & stiffness, warm, boggy, cyanotic, shiny joints |
deformities caused by RA | ulnar deviation of fingers, swan-neck wrist, Boutonniere deformity, nodules, flexion of PIP and extension of DIP joint |
diagnosis of RA | H&P, lab studies |
medications used for RA | ASA & other NASIDS, corticosteriods, immunosuppressive therapy (methotrexate) |
surgeries for RA | synovectomy, arthroplasty |
Gout | metabolic dosorder characterized by an elevated serum uric acid concentration and deposition of urate crystals in synovial fluid and surrounding joint tissues |
ppl affected by gout | 1-3.5% of US population, more men |
where gout develops | big toe, 1 joint at a time, serum uric acid level >7.0mg/dL |
acute gout | abrupt onset precipitated by trauma, alcohol, stress; acute pain, swollen joint, fever ,chills, malaise, evelvated WBC and sed rate |
chronic gout | Tophacceous gout |
medications for gout | NSAIDs, Colchicine, analgesics, corticosteriods |
other therapy for gout | bed rest, elevate joint, hot/cold compress, increased fluid intake, alcohol and sodium aviodance |
Burstits | infalmmation of irritation of bursa |
tendinitis | inflammation or irritation of a tendon |
Tx of bursititis and tendinitis | rest, splints, cold to hot compresses, NSAIDs, glucocorticoids |
6th leading cause of death in elderly | hip fractures |
manifestations of hip fracture | pain, shortening of affected extremity, external rotation of lower extremity |
CHF affects these ppl | 4 million; more african americans |
afterload | amount of force the left ventricle develops to eject blood into circulation |
preload | amount of cardiac muscle tension in ventricle |
stroke volume | amount of blood ejected from ventricle with each contraction (preload + afterload + contractility) |
CO | blood pumped in 1 min from ventricle (4-8L) |
Ejection Fraction | % of blood in ventricle at end of diastole that is ejected during systole (60%) |
causes of HF | too much volume, defects, HTN, MI, ETOH, CHD, cardiomyopathy, pericarditis, cardiac tamponade, stenosis of valve |
serum electrolytes in HF | serum osmolarity decreases d/t fluid retention; need baseline for diuretics |
ABG analysis in HF | decreased PO2, rises as CHF worsens |
chest x-ray findings for CHF | pulmonary vascular congestion and cardiomegaly |
echocardiogram for HF | evaluates LV function, hypertrophy, decreased contractility, decreased EF |
Cardiac Cath | shows presence of CAD |
Tx for CHF | ventricle pump performance-oxygen, digoxin reduce myocardial workload- diuretics, high fowlers position. reduce afterload- vasodilators, ACE's, Beta-Blockers |
Raynauds Disease | digital arteries respond excessively to vasospastic stimuli; diagnosed after 3 years |
blue-white-red disease | colors digits turn in Raynauds |
Iron deficient anemia | most common anemia |
s/s of iron deficient anemia | brittle nails, cheilosis, smooth & sore tongue, craving for starch, decreased Hbg |
Tx of iron deficient anemia | iron pills, foods high in iron |
Pernicious anemia | failure to absorb vit B12 |
s/s of pernicious anemia | low hbg, hct, RBC levels; pallor or jaundice, weakness/numbness sensations |
tx of pernicious anemia | cobalamin (B12) injections, increase foods high in B12 (meats, eggs, dairy products |
CVA | 3rd leasding cause of death in US; ischemic or hemorrhagic |
s/s of CVA | transient hemiparesis, loss of speech, vertigo or syncope, paresthesias, transient paralysis, epistaxis, HA |
Atrial fibrillation | lack of organized atrial activity and irregular timing of ventricular response |
causes of atrial fib | decreased # of SA node cells, HTN, CAD, valve problem |
s/s of atrial fib | heart racing, faint feeling, irregular heart beat |
Tx of atrial fib | digoxin, cardioversion |