NUR 211 Exam 3
Osteoporosis definition - ANS metabolic disease of bone demineralization, with the loss of
calcium and phosphorus salts
bone resorption accelerates as bone formation slows
occurs mainly in wrists, hips, vertebral column
cell regulation in osteoporosis - ANS osteoclasts (destroy bone) are overactive
osteoblasts (build bone) decrease
at what age does bone density peak - ANS 25-30 years
which bones are the most commonly attacked in osteoporosis - ANS spongy bones
primary osteoporosis - ANS postmenopausal
those with low testosterone levels
risk factors for primary osteoporosis - ANS decreased calcium intake
deficient estrogen
sedentary lifestyle
secondary osteoporosis - ANS prolonged tx with corticosteroids, thyroid-reducing meds,
aluminum-containing antacids, or antiseizure meds
associated with immobility, ETOH, malnutrition, or malabsorption
diseases r/t osteoporosis - ANS DM, hyperthyroidism, RA, bone cancer, prolonged
immobilization, HIV, cushing's
drugs r/t osteoporosis - ANS corticosteroids, antiseizure meds, barbiturates, cytotoxic agents,
immunosuppressants, loop diuretics, aluminum-based antacids
Risk factors for osteoporosis - ANS smoking, early menopause, excessive use of ETOH, family
hx, gender, age, insufficient calcium intake, sedentary lifestyle, thin/small frame, white or asian
assessment - osteoporosis - ANS pain with activity that relieves with rest
problems with balance
decline in ht
spinal changes
ht and wt
constipation
reflux
,resp changes
labs osteoporosis - ANS Ca(9-10.5)
vitamin D (25-80)
osteocalcin
bone specific alkaline phosphatase (BSAP)
Tests - osteoporosis - ANS XR
BMD (number 1 tool to determine osteoporosis)
MRI (density and composition)
DXA and pQUS (give T score that is used to diagnose)
nutritional therapy for osteoporosis - ANS calcium
vitamin D
no ETOH or caffeine
fruits and veggies
low fat dairy
protein
fiber
no atkins diet
exercises for osteoporosis - ANS low impact - swimming, yoga, walking
no jarring
30 mins 3-4x week
drug therapy for osteoporosis - ANS calcium and vitamin D3
biphosphates
estrogen agonists/antagonists
rankl inhibitors
biphosphates - ANS oral or IV
with water 30 mins before meal
don't lie down after taking
can cause osteonecrosis
check kidney fx
SERMs - ANS prevent or tx osteoporosis
not given with hx of DVT/PE
rankl inhibitors - ANS SQ
no LT
watch -lytes
dental exam
, osteoarthritis/DJD - ANS common type of arthritis characterized by the breakdown of cartilage
usually in hands, wrist, feet, back, shoulder, and weight-bearing joints
localized vs generalized OA - ANS local: 1-2 joints
gen: >3 joints
patho of OA - ANS progressive deterioration of joint cartilage and bone
excessive friction + risk factors
-thinning of articular cartilage
-narrowing of joint space
-loss of joint stability
-shallow pits form
-bone exposed in joint space
bone becomes dense and hard
etiology of OA - ANS progressive
idiopathic (aging) or secondary (trauma, inflammation, bone disease etc)
r/f for OA - ANS aging
RA
arteriosclerosis
obesity BMI > 25
trauma - sports, farming
family hx
inactivity
repetitive exercises
low estrogen
high PTH levels
health promotion for OA - ANS wt
smoking
avoid high impact exercises
active ROM
rest during exacerbations
heat - vasodilates
ice - reduces inflammation
isometric exercises - improve muscle tone
exercise 30 mins 3-4x week
assistive devices
glucosamine and chondroitin
cyclobenzaprine (muscle relaxant)
Glucosamine/Chondroitin - ANS OTC drugs
mimic synovial fluid
Osteoporosis definition - ANS metabolic disease of bone demineralization, with the loss of
calcium and phosphorus salts
bone resorption accelerates as bone formation slows
occurs mainly in wrists, hips, vertebral column
cell regulation in osteoporosis - ANS osteoclasts (destroy bone) are overactive
osteoblasts (build bone) decrease
at what age does bone density peak - ANS 25-30 years
which bones are the most commonly attacked in osteoporosis - ANS spongy bones
primary osteoporosis - ANS postmenopausal
those with low testosterone levels
risk factors for primary osteoporosis - ANS decreased calcium intake
deficient estrogen
sedentary lifestyle
secondary osteoporosis - ANS prolonged tx with corticosteroids, thyroid-reducing meds,
aluminum-containing antacids, or antiseizure meds
associated with immobility, ETOH, malnutrition, or malabsorption
diseases r/t osteoporosis - ANS DM, hyperthyroidism, RA, bone cancer, prolonged
immobilization, HIV, cushing's
drugs r/t osteoporosis - ANS corticosteroids, antiseizure meds, barbiturates, cytotoxic agents,
immunosuppressants, loop diuretics, aluminum-based antacids
Risk factors for osteoporosis - ANS smoking, early menopause, excessive use of ETOH, family
hx, gender, age, insufficient calcium intake, sedentary lifestyle, thin/small frame, white or asian
assessment - osteoporosis - ANS pain with activity that relieves with rest
problems with balance
decline in ht
spinal changes
ht and wt
constipation
reflux
,resp changes
labs osteoporosis - ANS Ca(9-10.5)
vitamin D (25-80)
osteocalcin
bone specific alkaline phosphatase (BSAP)
Tests - osteoporosis - ANS XR
BMD (number 1 tool to determine osteoporosis)
MRI (density and composition)
DXA and pQUS (give T score that is used to diagnose)
nutritional therapy for osteoporosis - ANS calcium
vitamin D
no ETOH or caffeine
fruits and veggies
low fat dairy
protein
fiber
no atkins diet
exercises for osteoporosis - ANS low impact - swimming, yoga, walking
no jarring
30 mins 3-4x week
drug therapy for osteoporosis - ANS calcium and vitamin D3
biphosphates
estrogen agonists/antagonists
rankl inhibitors
biphosphates - ANS oral or IV
with water 30 mins before meal
don't lie down after taking
can cause osteonecrosis
check kidney fx
SERMs - ANS prevent or tx osteoporosis
not given with hx of DVT/PE
rankl inhibitors - ANS SQ
no LT
watch -lytes
dental exam
, osteoarthritis/DJD - ANS common type of arthritis characterized by the breakdown of cartilage
usually in hands, wrist, feet, back, shoulder, and weight-bearing joints
localized vs generalized OA - ANS local: 1-2 joints
gen: >3 joints
patho of OA - ANS progressive deterioration of joint cartilage and bone
excessive friction + risk factors
-thinning of articular cartilage
-narrowing of joint space
-loss of joint stability
-shallow pits form
-bone exposed in joint space
bone becomes dense and hard
etiology of OA - ANS progressive
idiopathic (aging) or secondary (trauma, inflammation, bone disease etc)
r/f for OA - ANS aging
RA
arteriosclerosis
obesity BMI > 25
trauma - sports, farming
family hx
inactivity
repetitive exercises
low estrogen
high PTH levels
health promotion for OA - ANS wt
smoking
avoid high impact exercises
active ROM
rest during exacerbations
heat - vasodilates
ice - reduces inflammation
isometric exercises - improve muscle tone
exercise 30 mins 3-4x week
assistive devices
glucosamine and chondroitin
cyclobenzaprine (muscle relaxant)
Glucosamine/Chondroitin - ANS OTC drugs
mimic synovial fluid
