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osteoporosis 1
pn 141 test 1 book: med surg nursing pg 1047
Question | Answer |
---|---|
def of osteoporosis | "porous bones"; a bone disorder in which bone mass is lost. |
since the bones become more fragile, what does this increase the risk for | fractures |
who usually has it | women over the age of 60 |
what is the cause of it | unknown |
risk factors that cannot be changed | age, female gender, caucasian ir asian, family history, endocrine disorder |
risk factors that can be changed | calcium deficiency, estrogen deficiency, smoking, excessive alcohol intake, sedentary lifestyle, medications |
when is peak bone mass achieved (what age) | 35 yo |
after the age of peak bone mass, what can bone formation not keep up with? | reabsorption and bone mass is lost |
what are the names of the two types of osteoporosis | type 1 and type 2 |
what is type 1 osteoporosis | it occurs in women between the ages of 51 and 75 |
what is type 2 osteoporosis (senile) | affects both men and women over the age of 70, it develops more slowly and is associated with calcium deficiency |
s/s of it | loss of height, progressive curvature of the spine, low back pain, and fractures |
what causes one to lose height | as the vertabrea collapse height is lost |
why is a dowager's hump evident | b/c s/s of dorsal kyphosis and cervical lordosis develop |
what does the body so in order to maintain its center of gravity | the knees and hips flex and the abdomen protrude |
what is usually the first obvious sign of it | a fracture |
how do the fractures occur | some are spontanious, others from everyday activity (known as pathologic fractures) |
def of pathologic fractures | fractues that occur with minimal stress or no trauma |
what type of fractures are common | wrist, vertabrea, hip |
what is the care of a pt with it focused on | stopping or slowing the process, relieving s/s, and preventing complications |
what is bone density measurements used for; and who is it recommended for | it can help predict the risk for fractures; premenopausal women in their 40s |
calcium: what should the daily amount be | 1,000-1,500 (increase the amount to 1,500 when pregnent and increase amount when over 50 yo) |
calcium: why is it important to take | because it can slow bone loss, if taken before 30 it can increase peak bone mass and reduce the risk for osteoporosis |
calcium: foods high in calcium | dairy (milk, yogurt, cheese), tofu, sardines, clams, oysters, canned salmon, spinach, broccoli, cauliflower, bok choy, green beans, dark molasses |
meds: why is estrogen/hormone replacement therapy (HRT) or selective estrogen receptor modulators (SERMs) given | to prevent or treat bone loss in postmenopausal women |
meds: Bisphosphonates- names of these | alendronate (fosamax), risedronate (actonel) |
meds: Bisphosphonates- what do they do | inhibit bone resorption, increasing the bone density and reducing the risk of fractures. used to prevent and treat osteoporosis |
meds: Bisphosphonates- adminstering instructions | give with water on arising, 30 min before food or other meds, hold calcium suppliments and high calcium foods for 2 hours after admin, don't lie down until 30 min after taking drug, |
meds: Bisphosphonates- nursing implications | report changes in renal function (BUN and Creatinine) and serum electrolytes |
meds: Bisphosphonates- pt teaching | report heart burn, or painful swallowing, report tingling around mouth and nose, take calcium and vitemin d suppliments |
meds: calcitonin- names | calcitonin, calcimar, maicalcin |
meds: calcitonin- what does it do | it prevents further bone loss and increases bone mass if adequate vit D and calcium are consumed. may be used in post menopausal wm who cannot take estrogen |
meds: calcitonin- administering | alternate nostrils daily, take in evening, warm nasal spray to room temp |
meds: calcitonin- nursing implications | observe for possible anaphylactic reaction for 20 min, report any N/V, anorexia, mild flushing of hands or feet, and urinary frequency, |
meds: calcitonin- pt teaching | teach injection, rhinits is common, n/v will improve with continued treatment, still consume adequate calcium and vit D |
meds: fluoride- what does it do | stimulates bone growth by stimulating the proliferation of osteoblasts |
meds: fluoride- administering | give with crackers orbread to reduce nausea |
meds: fluoride- nursing implications | montior serum fluoride levels and report levels outside normal range (95-185 ng/ml) |
meds: fluoride- normal serum flouride levels | 95-185 ng/ml |
meds: fluoride- pt teaching | maintain adequate calcium intake |
why are weight bearing exercises helpful | promote bone growth (walking or low impact aerobics) |
is swimming a weight bearing exersice | no |
what is the most common spinal change | kyphosis, fm shrinks |
what is osteopenia | a precurser to osteoporosis |
side effects of calcium supplements | abd. discomfort, bloating, constipation, hypercalcemia |
why does calcium med have to be taken seperately with synthroid | b/c synthroid won't be absorbed |
med: evista (raloxifene): use | osteoporosis preventive tx |
med: evista (raloxifene): side effects | hot flashes, flulike s/s, arthralgia, rhinitis, increased cough, risk for DVT |