Chapter 42 med surge
An older adult woman's current medication regimen includes alendronate (Fosamax). What outcome would indicate successful therapy? Increased bone mass
Bisphosphonates such as Fosamax increase bone mass and decrease bone loss by inhibiting osteoclast function
A nurse is reviewing the pathophysiology that may underlie a patient's decreased bone density. What hormone should the nurse identify as inhibiting bone resorption and promoting bone formation?
Calcitonin Calcitonin inhibits bone resorption and promotes bone formation,
patient returned to the unit after undergoing limb-sparing surgery to remove a metastatic bone tumor. The nurse providing postoperative care in the days following surgery assesses for what complication from surgery?
Delayed wound healing
A patient's electronic health record notes that the patient has hallux valgus. What signs and symptoms would the nurse expect this patient to manifest?
Deviation of a great toe laterally
A patient presents at the clinic with complaints of morning numbness, cramping, and stiffness in his fourth and fifth fingers. What disease process should the nurse suspect?
Dupuytren's disease
A nurse is providing care for a patient who has a recent diagnosis of Paget's disease. When planning this patient's nursing care, interventions should address what nursing diagnoses?
Impaired Physical Mobility Acute Pain Disturbed Auditory Sensory Perception Risk for Injury
An older adult patient sought care for the treatment of a swollen, painful knee joint. Diagnostic imaging and culturing of synovial fluid resulted in a diagnosis of septic arthritis. The nurse should prioritize which of the following aspects of care?
Intravenous administration of antibiotics
A nurse is providing care for a patient who has osteomalacia. What major goal will guide the choice of medical and nursing interventions?
Maintenance of adequate levels of activated vitamin D
patient with diabetes has been diagnosed with osteomyelitis. nurse notes that the patient's right foot is pale and mottled, cool to touch, with a capillary refill of greater than 3 seconds. nurse should suspect what type of osteomyelitis?
Osteomyelitis with vascular insufficiency
A patient with diabetes is attending a class on the prevention of associated diseases. What action should the patient perform to reduce the risk of osteomyelitis?
Perform meticulous foot care.
A patient presents at a clinic complaining of back pain that goes all the way down the back of the leg to the foot. The nurse should document the presence of what type of pain?
Sciatica
A nurse is providing a class on osteoporosis at the local seniors' center. Which of the following statements related to osteoporosis is most accurate?
Slow discontinuation of corticosteroid therapy can halt the progression of the osteoporosis
A patient presents to a clinic complaining of a leg ulcer that isn't healing; subsequent diagnostic testing suggests osteomyelitis. The nurse is aware that the most common pathogen to cause osteomyelitis is what?
Staphylococcus aureus S. aureus causes over 50% of bone infections. Proteus, Pseudomonas, and E. coli are also causes, but to a lesser extent.
An orthopedic nurse is caring for a patient who is postoperative day one following foot surgery. What nursing intervention should be included in the patient's subsequent care?
The foot should be elevated in order to prevent edema.
A patient tells the nurse that he has pain and numbness to his thumb, first finger, and second finger of the right hand. The nurse discovers that the patient is employed as an auto mechanic, and that the pain is increased while working.
This may indicate that the patient could possibly have what health problem Carpel tunnel syndrome
A 32-year-old patient comes to the clinic complaining of shoulder tenderness, pain, and limited movement. Upon assessment the nurse finds edema. An MRI shows hemorrhage of the rotator cuff tendons and the patient is diagnosed with impingement syndrome.
What action should the nurse recommend in order to promote healing? Support the affected arm on pillows at night.
A nurse is caring for an adult patient diagnosed with a back strain. What health education should the nurse provide to this patient?
Avoid lifting more than one-third of body weight without assistance
A patient has been admitted to the medical unit for the treatment of Paget's disease. When reviewing the medication administration record, the nurse should anticipate what medications?
Calcitonin Bisphosphonates Bisphosphonates are the cornerstone of Paget therapy in that they stabilize the rapid bone turnover.
A nurse is collaborating with the physical therapist to plan the care of a patient with osteomyelitis. What principle should guide the management of activity and mobility in this patient?
Stress on the weakened bone must be avoided.
The health care team is caring for a patient with osteomalacia. It has been determined that the osteomalacia is caused by malabsorption. What is the usual treatment for osteomalacia caused by malabsorption?
Supplemental calcium and increased doses of vitamin D
A nurse is caring for a patient with a bone tumor. The nurse is providing education to help the patient reduce the risk for pathologic fractures. What should the nurse teach the patient?
Support the affected extremity with external supports such as splints.
A nurse is assessing a patient who reports a throbbing, burning sensation in the right foot. The patient states that the pain is worst during the day but notes that the pain is relieved with rest.
The nurse should recognize the signs and symptoms of what health problem? Morton's neuroma
A nurse is providing an educational class to a group of older adults at a community senior center. In an effort to prevent osteoporosis,
the nurse should encourage participants to ensure that they consume the recommended adequate intake of what nutrients? Calcium Vitamin D
Which of the following patients should the nurse recognize as being at the highest risk for the development of osteomyelitis
An elderly patient with an infected pressure ulcer in the sacral area Patients who are at high risk of osteomyelitis include those who are poorly nourished, elderly, and obese
nurse is caring for a patient with Paget's disease and is reviewing the patient's most recent laboratory values. Which of the following values is most characteristic of Paget's disease?
An elevated serum alkaline phosphatase level and a normal serum calcium level
An elderly female with osteoporosis has been hospitalized. Prior to discharge, when teaching the patient, the nurse should include information about which major complication of osteoporosis? Bone fracture
Bone fracture is a major complication of osteoporosis that results when loss of calcium and phosphate increases the fragility of bones.
A nurse is teaching a patient with osteomalacia about the role of diet. What would be the best choice for breakfast for a patient with osteomalacia?
Cereal with milk, a scrambled egg, and grapefruit
A nurse is caring for a patient who is being assessed following complaints of severe and persistent low back pain. The patient is scheduled for diagnostic testing in the morning. Which of the following are appropriate diagnostic tests for assessing low back pain?
Computed tomography (CT) Magnetic resonance imaging (MRI) Ultrasound X-ray
A patient has been admitted to the hospital with a spontaneous vertebral fracture related to osteoporosis. Which of the following nursing diagnoses must be addressed in the plan of care?
Constipation Related to Vertebral Fracture
A nurse is caring for a patient who is 12 hours postoperative following foot surgery. The nurse assesses the presence of edema in the foot. What nursing measure will the nurse implement to control the edema?
Elevate the foot on several pillows.
A nurse is planning the care of an older adult patient with osteomalacia. What action should the nurse recommend in order to promote vitamin D synthesis?
Ensuring adequate exposure to sunlight
A patient presents at a clinic complaining of pain in his heel so bad that it inhibits his ability to walk. The patient is subsequently diagnosed with plantar fasciitis. This patient's plan of care should include what intervention?
Gently stretching the foot and the Achilles tendon
A nurse is caring for a patient who is being treated in the hospital for a spontaneous vertebral fracture related to osteoporosis. The nurse should address the nursing diagnosis of Acute Pain Related to Fracture by implementing what intervention?
Intermittent application of heat to the patient's back
A nurse is discussing conservative management of tendonitis with a patient. Which of the following may be an effective approach to managing tendonitis?
Intermittent application of ice and heat
A patient is undergoing diagnostic testing for osteomalacia. Which of the following laboratory results is most suggestive of this diagnosis?
Low serum calcium and low phosphorus level
A nurse is providing discharge teaching for a patient who underwent foot surgery. The nurse is collaborating with the occupational therapist and discussing the use of assistive devices. On what variables does the choice of assistive devices primarily depend?
Patient's general condition, balance, and weight-bearing prescription
A nurse is reviewing the care of a patient who has a long history of lower back pain that has not responded to conservative treatment measures. The nurse should anticipate the administration of what drug? Cyclobenzaprine
Short-term prescription muscle relaxants cyclobenzaprine Flexeril are effective in relieving acute low back pain.
A nursing educator is reviewing the risk factors for osteoporosis with a group of recent graduates. What risk factor of the following should the educator describe?
Small frame, female gender, and Caucasian ethnicity
A patient has come to the clinic for a routine annual physical. The nurse practitioner notes a palpable, painless projection of bone at the patient's shoulder. The projection appears to be at the distal end of the humerus.
The nurse should suspect the presence of which of the following?Osteochondroma Osteochondroma is the most common benign bone tumor. It usually occurs as a large projection of bone at the end of long bones (at the knee or shoulder).
An 80-year-old man in a long-term care facility has a chronic leg ulcer and states that the area has become increasingly painful in recent days. The nurse notes that the site is now swollen and warm to the touch.
The patient should undergo diagnostic testing for what health problem? Osteomyelitis When osteomyelitis develops from the spread of an adjacent infection, no signs of septicemia are present, but the area becomes swollen, warm, painful, and tender to touch.
