N320 - Med Surg Exam 1
which assessment data are factors increase the risk for osteoporosis for an older Euro-American female?
drinks 3-4 glasses of wine each day sits at a desk all day in her job smokes a pack of cigarettes a day weighs 110 lbs (50kg)
the nurse assesses a client recently diagnosed with metastatic vertebral bone cancer. which intervention is the priority when caring for this client?
drug therapy to manage persistent pain
the nurse is teaching a postmenopausal client about the need for bone health and screening what diagnostic test would the nurse recommend?
dual x-ray absorptiometry (DXA)
the nurse is reviewing the lab test results of a client with a recently diagnosed osteosarcoma. what abnormal laboratory finding would the nurse expect for this client?
elevated alkaline phosphatase
RA lab findings
elevated rheumatoid factor, antinuclear antibody, ESR
transverse fracture
fracture is straight across the bone shaft
the nurse is caring for a client who was admitted with a draining diabetic ulcer on the lower extremity. what personal protective equipment with the nurse teach the staff to use?
gown gloves
which risks factors are shared by male clients who have osteoporosis or osteomalcia?
high alcohol intake history of smoking
the nurse is caring for female client who has a right wrist ganglion which is interfering with her ability to do her job as administrative assistant. what collaborative treatment would the nurse anticipate for this client?
removal of ganglion
the nurse is teaching a client who has osteopenia about alendronate. which statement by the client indicates a need for further teaching?
"I will take this drug at night to prevent nausea"
an older adult client who has osteoporosis is discharge from the hospital. what does the nurse include in health teaching related to the clients home safety?
"keep walkways free of clutter"
a young female client whose mother and grandmother have osteoporosis asks whether she needs to take steps to prevent this disease in herself. what will the nurse tell this client?
"now is the time to begin strong bones"
a client who has osteopenia is prescribed to begin risedonate. what health teaching would the nurse include about this drug?
"remain in an upright position for 30 minutes after taking the drug"
T-Score for normal bone density
-1 to +4
T-Score for osteopenia
-1 to -2.5
the nurse is caring for a client who diagnosed with osteopenia. which T-score will the nurse expect to see for this client after bone mineral density (BMD) test?
-2
T-Score for osteoporosis
-2.5 to -4
RA typical onset age
35-45 years
RA common drug therapy
NSAIDs (short-term) methotrexate lelfunoide biological response modifiers immunosuppressive agents
nonmodifiable risk factors for osteoporosis
age (over 50) menopause or hx of total hysterectomy (including ovaries) parental hx euro-caucasian/asian ethnicity eating disorders rheumatoid arthritis history of low-trauma fracture after age of 50
Most common bisphosphonate
alendronate
the nurse is caring for a client immediately after a bunionectomy. what is the nurses priority action?
assess neurovascular status in the surgical foot
RA risk factors/cause
autoimmune emotional stress (trigger) environmental factors
RA disease pattern
bilateral, symmetric, multiple joints usually affects upper extremities first distal interphalangeal joints of hands spared systemic
fracture that is broken into two
complete fracture
fracture that breaks through the skin
compound fracture (open)
the nurse is assessing an older adult client who has severe kyphosis. what psychosocial client problem would the nurse anticipate?
depression
osteoporosis defintion
decreased bone mass caused by multiple factors
fracture that only part is broken
incomplete fracture
RA disease process
inflammatory
osteoporosis primary etiology
lack of calcium and estrogen or testosterone
modifiable risk factors for osteoporosis
low body weight, thin build chronic low Ca/vitamin D intake estrogen/androgen deficiency smoking/alcohol intake drug therapy (steroids) poor nutrition lack of physical exercise/prolong decreased mobility
osteoporosis calcium level
low/normal
a client is admitted to the same-day surgical center PACU after bunionectomy. after assessing the clients ABC's, what is the priority assessment for the client?
neurovascular assessment
greenstick fracture
one side of the bone is bent while the other is broken (most common in peds)
osteoporosis radiographic findings
osteopenia (bone loss), fractures
THA post-op
posterolateral/direct lateral surgical approach: bend hips no more than 90 degrees anterior surgical approach: no hyperextend of leg behind
the primary health care provider prescribes daily celecoxib for a client experiencing persistent joint pain in both knees. which health teaching will the nurse provide for the client regarding this drug for long term pain control?
report any sign of bleeding, including bloody or dark, tarry stool do not take other NSAIDs while on celecoxib report any major changes in the amount of urine excrete each day
the nurse suspects that a client may have planter fasciitis if the client has which assessment finding?
severe pain in the arch of the foot, especially when getting out of bed
fracture that does not break the skin
simple fracture (closed)
comminuted fracture
the bone is broken into many fragments (3 or more)
oblique fracture
the fracture is slanted across the bone shaft
spiral fracture
the fracture twists around the bone shaft (twisting injury)
the nurse is caring for an older adult client diagnosed with osteomalacia. the nurse anticipates that the primary health care provider will request which supplement?
vitamin D
what will the nurse recommend as the most appropriate way to decrease the risk for osteoporosis in a client who has just been determined to be at high risk for the disease?
walk for 30 minutes three times a week
a middle-age female client has osteoporosis and is at risk for developing vertebral fractures. she asks the nurse about exercises to help minimize the risk. which exercise will nurse recommend?
yoga