Bones, Joints, and Beyond

What is contraindicated in using alendronate?

Abnormalities of the esophagus

What is the purpose of tretinoin?

Acne, fine wrinkles/liver spots

What does the thyroid gland cause for calcium, when calcitonin is released?

Addition of calcium to bone, and Decreased absorption of calcium in small intestine

What are some nursing interventions/education for adalimumab?

Administration of live vaccines should be avoided, avoid use with active infections, counsel about increased risk of malignancy, given subQ, may need education.

What foods should be avoided with gout?

Alcohol, Purine, red meat, organ meat, some seafood, anchovies, sardines, mussels, scallops, trout, tuna

What Class of drug is tretinoin?

Antiacne/retinoid

What class of drug is timolol?

Antiglaucoma drug/beta-adrenergic antagonist

What class of drug is colchicine?

Antigout Anti-inflammatory

What class of drug is permethrin?

Antiparasitic/Scabicide (cause paralysis on the adult mites)

What is contraindicated in timolol?

Asthma, severe COPD, sinus bradycardia, second-or-third-degree atrioventricular block, heart failure, cardiogenic shock, or hypersensitivity to the drug.

What are some nursing interventions/education for tretinnoin?

Avoid concurrent use of harsh skin cleaning products, and other keratolytic agents, wear sunblock. Avoid open areas of skin

Osteoblast are

Bone deposition/building

What are some nursing interventions/education with allopurinol?

Can be taken PO or IV, with or without food

What do you need to consider when calcium is ordered with digoxin?

Can cause severe bradycardia.

What are some nursing interventions/education for probenecid?

Can take with food, and encourage fluid intake

What class of drug is acetazolamide?

Carbonic anhydrase inhibitor

What class of drug is adalimumab?

DMARD TNF antagonist

What are some good sources of calcium?

Dairy, milk, cheese, yogurt, broccoli, COOKED spinach, fortified cereals, tofu

S&S hypocalcemia

Decreased Vit D and Ca in diet, Vomiting, malabsorption, CKD, Decreased PTH after surgery, convulsions, arrhythmias, tetany, stridor and spasms

What are some adverse effects of Alendronate?

Esophagitis, musculoskeletal pain, ocular inflammation, ONJ

What are some adverse effects of probenecid?

GI effects, rash, renal impairment, avoid initiating therapy during acute attack.

What are some adverse effects of colchicine?

GI upset, myelosuppression, myopathy

A client has been prescribed alendronate for the prevention of osteoporosis. Which is the highest priority nursing intervention associated with the administration of the medication?

Have the client sit upright for at least 30 minutes following administration

A nurse should advise a client with gout to avoid which foods?

Organ meats and scallops

What is the purpose of Alendronate?

Osteoporosis in postmenopausal women, male osteoporosis, paget's disease, corticosteroid induced osteo

What are some Adverse effects of acetazolamide?

Paresthesia, malaise, fatigue, GI, electrolyte imbalance

What is the black box warning label for adalimumab?

Patients are at increased risk for development of serious infections and malignancies?

What is the purpose of Raloxifene?

Postmenopausal osteoporosis, reduces RISK of estrogen receptor breast cancer

What is contraindicated in the use of Raloxifene?

Pregnancy

What is the purpose of adalimumab?

RA, psoriasis, Chron's disease or ulcerative colitis

What foods can suppress calcium absorption?

Raw spinach, cooked bad spinach, good rhubarb,, swiss chard, and beets

What is the purpose of latanoprost?

Reduces IOP by increasing the outflow of aqueous humor. It is used to treat open angle glaucoma.

What are some nursing interventions/education for latanoprost?

Remove contacts and leave out for 15 minutes. Wait for 5 minutes between different eye drop medications, avoid touching any part of the eye with the dropper, apply gently pressure to nasolacrimal duct 30-60 seconds.

What are some nursing interventions/education for permethrin?

Removing nits with a nit comb 2-3 weeks, washing bedding in HOT water, Cleaning or removing objects that have been in contact with the head or hair, used cautiously over inflamed skin, avoid conditioner, in those with asthma.

What are some drug interactions with probenecid?

Salicylates interfere with MOA and decrease therapeutic effects.

What class of drug is Raloxifene?

Selective estrogen receptor modulator (SERMs)

What foods are high in Vitamin D?

Shiitake muschrooms, oily fish, fortified foods like cereals and milk.

The nurse is planning health teaching for a patient who has been prescribed latanoprost (Xalatan) drops for open-angle glaucoma. The nurse should include which of the following in the teaching plan?

The drops may cause darkening and thickening of the eyelashes and upper lid and darkening of the iris color.

What is the purpose of allopurinol?

To reduce hyperuricemia that causes severe gout and to reduce the risk of acute gout attacks. Long term use to prevent attacks. Prevent kidney stones and prophylactically to reduce the severity of the hyperuricemia

What is the purpose of colchicine?

Treat gouty attack and prevention (second choice after NSAIDS for acute attack)

What is the purpose of probenecid?

Treats gout by increasing excretion of uric acid

When should calcium be taken with other drugs and why?

Typically two hours away from other medications because it can affect absorption.

What class of drug is probenecid?

Uricosuric agent

What are some nursing interventions/education for timolol?

Use with caution if client is on other beta-blocking agents.

What is the purpose of permethrin?

Used to kill lice and mites (not effective to ova)

What are some nursing interventions/education with alendronate?

Usually dosed daily or weekly, empty stomach in AM with 8oz water, sit upright for at least 30 minutes after, DO NOT CHEW, Do not use with alcohol, Encourage intake of Ca and Vit. D, weight bearing exercises are encouraged and monitor bone density.

What class of drug is Calcitriol?

Vitamin D

What is Osteomalacia?

Vitamin D deficiency in adults.

What Vitamin do we need to help absorb Calcium?

Vitamin D, which releases Calcitriol, which helps us absorb.

What class of drug is allopurinol?

Xanthine oxidase inhibitor

A nurse is providing care for a client who has just been diagnosed with early-stage rheumatoid arthritis (RA). The nurse should anticipate the administration of which medication?

adalimumab

What class of drug is latanoprost?

antiglaucoma drug/prostaglandin drug

What is contraindicated with calcitriol?

hypercalcemia

Identify education topics important to provide clients starting tretinoin therapy.

Avoid use of harsh skin cleansers. Wear sunblock. Avoid open areas of skin

What class of drug is Alendronate?

Bisphosphonate (bone resorption inhibitor, decreasing osteoclast activity

What are the 3 mechanisms of the parathyroid gland for calcium?

Bone resorption, increase reception from the kidneys, increased absorption from the intestines.

Osteoclasts are

Bone resorption/demineralization

What are some adverse effects of latanoprost?

Brown pigmentation of the iris, increase pigmentation of the eyelid, thickness and pigmentation of eyelashes, blurred vision, stinging, migraine

A physician prescribes raloxifene to a hospitalized client. The client's history includes a right hip fracture, hysterectomy, deep vein thrombosis, and hypertension. Which action by the nurse demonstrates safe nursing care?

Holding the raloxifene and notifying the physician

What are the adverse effects of calcitriol?

Hypercalcemia, BACKME, Vit. D hypercalcemia can affect digoxin levels.

What are the adverse effects of calcium salts?

Hypercalemia: which can cause lethargy, weakness, anorexia, nausea, vomiting, confusion, kidney stones, increased urination, dehydration, syncope, coma, dysrhythmias, and cardiac arrest.

What are some adverse effects of allopurinol?

Hypersensitivity syndrome, GI upset, drowsiness, cataracts, bone marrow suppression

What is the therapeutic use for Calcitriol?

Hypoparathyroidism, and CKD

Why would a patient be on Calcium salts?

If a patient is low on calcium

What are some adverse effects of Raloxifene?

Increased risk of embolic event, fetal harm and is a cat X drug in pregnancy

What is the Black box warning with Raloxifene?

Increases r/o VTE and death from strokes

What are some adverse effects with adalimumab?

Injection site pain, infection, heart and liver failure, cancer

The patient is treated for head lice with permethrin (Nix). Following treatment, the nurse will reinforce which instruction?

Inspect the hair shafts, checking for nits daily for 2 to 3 weeks following treatment

A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse?

It lowers serum and uric acid levels.

What are some adverse effects of permethrin?

Local reactions, itching redness/edema, burning

What are adverse effects of tretinoin?

Localized reactions, blistering, peeling, crusting, burning, edema, increased risk of sunburn

What is the purpose of acetazolamide?

Lowers IOP by decreasing production of aqueous humor. can we giving IV or PO

What is the purpose of timolol?

Lowers IOP in chronic open-angel glaucoma by reducing the formation of aqueous humor

S&S of hypercalcium

Malignancy, overactive parathyroid, immobility, medications, bone pain, arrhythmias, Cardiac arrest, Kidney stones, muscle weakness, excess urination.

The school nurse is instructing a parent in the care and elimination of lice from their child's hair. The parent brings all of the products for care in a bag. Which contents are not appropriate for use?

Shampoo and conditioner

How should calcium be infused?

Should be infused over one hour slowly

Which activities should the nurse instruct a client to perform to reduce the risk of osteoporosis?

Stair climbing, dancing, and weight lifting

What are some drug interactions with colchicine?

Statins, cyclosporine, ranolazine, ketoconazole, clarithromycin, and HIV protease inhibitors can cause life threatening toxic levels

What are some adverse effects of timolol?

Stinging, burning, systemic effects: bradycardia, bronchospasm

What are some ways to get inactive cholecalciferol ?

Sun, skin, and diet