Chronic: Exam 2: Chapter 41: PREP U
what is a diagnostic finding for Paget's disease
alkaline phosphate of 165 IU/L
what is a diagnostic finding for a patient with paget's disease
alkaline phosphate of 165 IU/L
what is plantar fasciitis
an inflammation of foot-supporting fascia, presents as acute-onset heel pain experienced upon taking first steps in the morning
instructions for a client with low back pain include that, when lifting, the client should
avoid overreaching
client has paget disease. what is an appropriate nursing diagnosis for this client
risk for falls
a patient is having low back pain. what position can the nurse suggest to relieve this discomfort?
supine, with the knees slightly flexed and the head of the bed elevated 30 degrees
in chronic osteomyelitis, antibiotics are adjunctive therapy in which situation?
surgical debridement
how would the nurse best describe carpal tunnel syndrome?
"CTS is a neuropathy that is characterized by compression of the median nerve at the wrist"
risk lowering strategies for osteoporosis
- walking or exercising outdoors - performing weight bearing exercises - increase dietary calcium and vitamin D intake - smoking cessation - consuming caffeine and alcohol in moderation
what is the recommended daily dosage of calcium and vitamin D for a woman over 50
1,200 mg calcium 1,000 IU vitamin D
the origin of pain with sciatica is between what intervertebral disks?
L4, L5, S1
patient has pain beginning in his low back and radiating behind his right thigh down below his right knee. the doctor suspects a diagnosis of sciatica. the nurse knows that the origin of the pain is between these intervertebral disks:
L4, L5, and S1 the lower lumbar disks (L4, L5, S1) are subject to the greatest stress and the greatest degenerative chances
what is flatfoot
a common disorder in which the longitudinal arch of the foot is diminished
what is pes cavus
a foot with an abnormally high arch and a fixed equinus deformity of the forefoot
what is contracture
abnormal shortening of muscle or fibrosis of joint
a client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. when planning client care, the nurse should anticipate which measure?
administering large doses of IV antibiotics as ordered
nurse is caring for a client with a hip fracture. the physician orders the client to start taking a bisphosphonate. what medication would the nurse document as given?
alendronate
what is an example of a biphosphonate?
alendronate
a patient is diagnosed with osteogenic sarcoma. what lab studies should the nurse monitor for the presence of elevation?
alkaline phosphatase serum alkaline phosphatase levels are frequently elevated with osteogenic sarcoma or bone metastasis
which medication classification is prescribed when allergy is a factor causing the skin disorder?
antihistamines they relieve itching and shorten the duration of allergic reaction
the nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. what procedure will the nurse prepare the client for?
arthroscopy
the recognizes that the client with osteomyelitis is at risk for what?
bone abscess formation
a patient has been diagnosed with osteomalacia. what common symptoms does the nurse recognize that correlate with the diagnosis?
bone pain and tenderness
what inhibits bone resorption and promotes bone formation?
calcitonin calcitonin is decreased in osteoporosis. estrogen decreases with aging. PTH increases with aging, increasing bone turnover and resorption. The consequence of these changes is net loss of bone mass over time.
what medication directly inhibits osteoclasts, thereby reducing bone loss and increasing BMD
calcitonin (miacalcin)
what lab value may indicate the presence of a disease complication in a client with bone cancer?
calcium level of 11.6 mg/dl
overgrowth of the horny layer of the epidermis is called what
corn
what is sequesttrum
dead bone in an abscess cavity
client with osteosarcoma is scheduled for an amputation. what nursing diagnosis is a priority for this client compared with other surgical clients?
disturbed body image
term that refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia
dupuytren contracture
what term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia?
dupuytren contracture
diagnostic used to evaluate spinal nerve root disorders
electromyogram
dupuytren contracture causes flexion of which area?
fourth and fifth fingers
deformity that causes the great toe to deviate laterally
hallux vagus
which of the following was formerly called a bunion?
hallux valgus
nurse observes a flexion deformity of the proximal interphalangeal joint of two toes on the right foot. the nurse documents this finding as what?
hammer toe
what is the name of the condition that causes a flexion deformity of the proximal interphalangeal joint
hammer toe
how do you test a patient for Tinel's sign to diagnose carpal tunnel syndrome?
hold his hand up while the nurse percusses over the median nerve
the recommended daily allowance of calcium may be found...
in a wide variety of foods. clients can usually get the recommended daily requirement of calcium by eating a varied diet
what is plantar fasciitis
inflammation of the foot-supporting fascia
which assessment findings would the nurse expect in a client diagnosed with osteomyelitis?
leukocytosis and localized bone pain
which area of the spinal column is subject to the greatest mechanical stress and degenerative changes?
lower lumbar
what should be included in the teaching plan for a client diagnosed with plantar fasciitis?
management of plantar fasciitis includes stretching exercises management also includes wearing shoes with support and cusioning to relieve pain, orthotic devices, and the use of nonsteroidal anti-inflammatory drugs.
the nurse is caring for a client following foot surgery. what nursing intervention is most important to include in the nursing care plan
perform neuromuscular assessment every hour early detection of neurological and perfusion problems is critical
the nurse is caring for the client following removal of a Morton's neuroma. what is an appropriate nursing intervention?
perform neurovascular assessment of the hand
a patient had hand surgery to correct a Dupuytren's contracture. what nursing intervention is a priority postoperatively?
performing hourly neurovascular assessments for the first 24 hours
nurse is educating client with low back pain on proper lifting techniques. the nurse knows the teaching is effective when the client
places the load close to the body ALSO; "i will avoid prolonged sitting or walking"
what presents with an onset of heel pain with the first steps of the morning?
plantar fasciitis
term that refers to disease of a nerve root
radiculopathy
what term refers to the disease of a nerve root?
radiculopathy when the client reports radiating pain down the leg, they are describing radiculopathy.
what is a drug that belongs to the class of selective estrogen receptor modifier (SERM)?
raloxifene
what is the only selective estrogen receptor modulator approved for osteoporosis in post menopausal women?
raloxifene
a client with osteoporosis is prescribed a selective estrogen receptor modifier (SERM) as treatment. this drug belongs to what class?
raloxifene (evista)
what discharge instruction for an elderly woman with osteoporosis about taking a calcium supplement should the nurse include?
take the supplement with meals or with orange juice
which sign may be helpful in identifying carpal tunnel syndrome?
tinel's
the nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action?
walk or perform weight-bearing exercises outdoors
a nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. what exercise is appropriate?
walking
the nurse is assisting a client with removing shoes and observes that the client has a flexion deformity of several toes on both feet of the proximal interphalangeal (PIP) joints. what can the nurse encourage the client to do?
wear properly fitting shoes
nurse is planning discharge instructions for the client with osteomyelitis. what instructions should the nurse include in discharge teaching?
you will receive IV antibiotics for 3-6 weeks treatment of osteomyelitis requires IV antibiotics for 3-6 weeks
what diagnostic procedure is used to rule out the presence of a tumor?
bone scan
what deformity causes the big toe to deviate laterally?
hallux valgus
when the home health nurse visits a client with osteomalacia, what should be a focus point of the visit?
observing for safety hazards that could be a fall risk
a metabolic bone disease characterized by inadequate mineralization of bone
osteomalacia
a client has fever, chills, restlessness, and limited movement of a fractured jaw. the nurse interprets these findings as indicating what complication?
osteomyelitis
a client with Paget's disease comes to the hospital with difficulty urinating. what does the nurse suspect as being the most likely cause of the client's urination problem?
renal calculi
a client has paget's disease. an appropriate nursing diagnosis for this client is
risk for falls the client with paget's disease is at risk for falls secondary to pathological fractures and impaired gait/mobility
what is the most important nursing diagnosis for an elderly patient diagnosed with osteoporosis?
risk for injury related to fractures due to osteoporosis the most important concern for an elderly patient with osteoporosis is the prevention of falls and fractures
which group is at the greatest risk for osteoporosis?
small-framed, nonobese caucasian women are at greatest risk for osteoporosis african american women have a greater bone mass than caucasian women and are less susceptible to osteoporosis
most cases of osteomyelitis are caused by what organism?
staphylococcus aureus staph a. causes 70-80% of bone infections. proteus species, pseudomonas species, and e. coli are frequently found in osteomyelitis but do not cause the majority of bone infections
what food can the nurse suggest to the client at risk for osteoporosis?
broccoli
client reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. the nurse recognizes that this finding is consistent with:
carpal tunnel syndrome
symptoms of hypercalcemia
muscle weakness, fatigue, anorexia, nausea, vomiting, polyuria, cardiac dysrhythmias, seizures, and coma.
what is incolucrum
new bone growth around the sequestrum
a client with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. the wound appearance has not improved. what action would the nurse anticipate to promote healing?
surgical debridement
morton neuroma is exhibited by which clinical manifestation?
swelling of the third (lateral) branch of the median plantar nerve
a nurse is caring for a client who's experiencing septic arthritis. the client has a history of immunosuppressive therapy and his immune system is currently depressed. which assignment is the most appropriate for the nurse caring for this client?
the nurse is caring for this client on the intensive care unit
