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NURS310- exam 3

QuestionAnswer
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
Created by: rsg175
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