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Terms
- Bone mineral density- mineral contents of the bone
- crepitus- crunch in knee- air and fluid in the tissue. sound or feel of bones rubbing on bone
- osteopenia: loss of bone mineral density/structure at a mild/moderate levels
- Osteolyte- excessive bone growth
- osteoporosis: loss of bone mineral density/structure to a great degree. suppose 2 be a balance
- resorption: loss of substance or bone by physiological or pathological process
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Osteoporosis risk factor
- Menopause
- smoking
- lack of calcium
- sedentary lifestyle
- life long cortocordsteriod
- thin women
- causian and asian
- fhx
- age
- weight (underweight)
- good nutrition
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Osteoporosis decrease risk factors
- weight bearing excerise
- lifting light weights
- good nutrition
- Ca, Vit D
- no smoking
- lifestyle changes
- peak bone mass at 30yrs
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Osteoporosis- dietary implication
- green leafy veggies
- milk
- diary products
- yogurt
- sardines- bony fish that is edible
- cheese
- soy milk
- pizza
- tofu
- orange juice
- soybeans
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Osteoporosis- pharmacology
- vita D
- Ca 1200mg (maybe more)- tums
- - this causes constipation
- estrogen replacement therapy
- - short term 1-2yrs
- - contraindicated hx of breast cancer, GYN cancer
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Osteoporosis- nursing teaching
- diet- that will not excrete Ca
- no excessive alcohol, caffiene
- constipation- incre fluids
- can cause stones in the kidneys
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Osteoarthritis
- wear and tear on the joints (esp the one that carries weight, like hip and knee sometimes arms/hands and elbows)
- desruption in bone surfaces no fluids- bone on bone
- swollen painful, deformity, stiff w/activity painful with activity
- maybe stiff in the morning
- end results in the same as RA
- NSAIDS becareful with elders for bleeding
- if do not work than replacement
- no cure
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Rheumatoid arthritis
- systemic chronic autoimmune disease
- joint damage cause by autoimmune reaction
- inflammation of the joints. changes in cartilidge
- nodules on hand (on women) bc it effects the entire body
- all joints are affected
- weight loss or gain- not moving or not eating
- painful in morning
- flu like symptoms- bc general body responds
- warm joints, tender
- treatments:
- NSAIDS
- Cox 2 inhibitor
- methotrexate- higher doses used for cancer
- joint replacement
- corticordsteriod- DM a crazy cycle
- end is the same
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Gout
- disease of kings
- inability to metabolize purines (breakdown of proteins, which breaks down into uric acid, uric acid crystals- deposit self in joints- called porphi)
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Gout assessment
- Usually found in the big
- painful- even a light wind can irritate this
- red, swollen
- other places ankle, wrist, elbow
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Gout- pharm
- NSAIDS
- Allopurinol- decre uric acid level
- Colchicine- decre inflammation
- Probenecid- get rids of the uric acid in kidneys
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Gout- dietary implications
- be careful of food with purines- asparus, game meat, beef kidney, gravy, sweet, bread
- Hydrate the pt to get it out
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Gout nursing implications
- alcohol- be careful- prevents excretion of uric acid from the kidneys
- she didn't ask about diet on the test
- be careful of S/e of meds
- watch renal function
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overview
- what will you see in the joints
- imflammation, swollen, mobility, pain, nodules, red/heat, crepitus
- ADL, IADL- does it interfere with their life
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