Duchenne Muscular Dystrophy Assessment Quiz
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Questions and Answers

Which of the following signs and symptoms would be assessed during a cardiovascular assessment in a patient with a suspected muscular dystrophy?

  • Dyspnea
  • Palpitations
  • Edema
  • All of the above (correct)

During a respiratory assessment, which of these findings could indicate respiratory impairment in someone with muscular dystrophy?

  • Wheezes
  • Crackles
  • Orthopnea
  • All of the above (correct)

What would be assessed during the GI assessment of a patient suspected of having muscular dystrophy?

  • Bowel habits
  • Abdominal distention
  • Fluid and electrolyte balance
  • All of the above (correct)

Which of these findings would be considered during a GU assessment of a patient with a suspected muscular dystrophy?

<p>All of the above (D)</p> Signup and view all the answers

What protein is deficient in Duchenne muscular dystrophy?

<p>Dystrophin (B)</p> Signup and view all the answers

Which of the following assessments is specifically focused on evaluating the patient’s muscle function and integrity?

<p>MSK (D)</p> Signup and view all the answers

Which of the following is NOT a clinical manifestation of Duchenne muscular dystrophy?

<p>Increased muscle strength (B)</p> Signup and view all the answers

Which of the following is a diagnostic test for Duchenne muscular dystrophy?

<p>Genetic testing (C)</p> Signup and view all the answers

What is the primary goal of nursing interventions for patients with Duchenne muscular dystrophy?

<p>Prevent complications (D)</p> Signup and view all the answers

Which of the following is a common nursing assessment for patients with Duchenne muscular dystrophy?

<p>Assessing for pain (D)</p> Signup and view all the answers

Which of the following is a common nursing intervention for patients with Duchenne muscular dystrophy?

<p>Providing nutritional counseling (A)</p> Signup and view all the answers

What is the most common clinical manifestation of Duchenne muscular dystrophy?

<p>Muscle weakness (A)</p> Signup and view all the answers

What is the typical onset of Duchenne muscular dystrophy?

<p>Early childhood (A)</p> Signup and view all the answers

What is the primary effect of osteoporosis on bone?

<p>Reduction in both quantity and quality of bone tissue (D)</p> Signup and view all the answers

Which of the following hormones is NOT directly associated with bone metabolism in osteoporosis?

<p>Insulin (D)</p> Signup and view all the answers

Which type of osteoporosis primarily affects postmenopausal women?

<p>Primary osteoporosis (D)</p> Signup and view all the answers

What is a characteristic feature of secondary osteoporosis?

<p>Less common and can affect anyone regardless of hormonal status (D)</p> Signup and view all the answers

In which areas of the body do osteoporosis-related fractures most commonly occur?

<p>Wrists, hip, and vertebral column (C)</p> Signup and view all the answers

Which of the following is a potential method for preventing primary osteoporosis?

<p>Lifestyle modifications and medications (A)</p> Signup and view all the answers

What role does RANK play in osteoclast function during bone resorption?

<p>It stimulates osteoclast differentiation and activity (A)</p> Signup and view all the answers

Which statement about fractures related to osteoporosis is accurate?

<p>They occur more frequently than cardiovascular diseases combined (C)</p> Signup and view all the answers

What is a common consequence of the breakdown of cartilage in osteoarthritis (OA)?

<p>Narrowing of the joint space (D)</p> Signup and view all the answers

Which demographic factor is most strongly associated with an increased risk of developing OA?

<p>Having a family history of OA (B)</p> Signup and view all the answers

Which of the following is a clinical manifestation of osteoarthritis?

<p>Joint swelling and tenderness (B)</p> Signup and view all the answers

What is one of the main steps in the pathophysiology of OA?

<p>Release of enzymes damaging cartilage (D)</p> Signup and view all the answers

Which of the following lifestyle factors can increase the risk of developing OA?

<p>Obesity (A)</p> Signup and view all the answers

What diagnostic test is commonly used to assess the severity of osteoarthritis?

<p>X-ray studies (A)</p> Signup and view all the answers

What additional factor may influence the development of secondary osteoarthritis?

<p>Past joint injury (C)</p> Signup and view all the answers

What term describes the bone formations that can develop in osteoarthritis?

<p>Bone spurs (A)</p> Signup and view all the answers

Which statement accurately describes primary osteoarthritis?

<p>It has no known cause and is related to aging. (A)</p> Signup and view all the answers

What is a common symptom that worsens with activity in patients with osteoarthritis?

<p>Joint pain (D)</p> Signup and view all the answers

What type of arthritis primarily attacks the lining of joints?

<p>Rheumatoid arthritis (C)</p> Signup and view all the answers

What is a common symptom of osteoarthritis?

<p>Crepitus in the joint (C)</p> Signup and view all the answers

What laboratory tests are commonly monitored for assessing rheumatoid arthritis?

<p>ESR, CRP, RF, ANA (A)</p> Signup and view all the answers

Which metabolic bone disease is characterized by porous and fragile bones?

<p>Osteoporosis (D)</p> Signup and view all the answers

What is a primary treatment approach for a patient with rheumatoid arthritis?

<p>Supportive devices and self-management education (B)</p> Signup and view all the answers

What symptom would most likely indicate a patient is suffering from osteomalacia?

<p>Bone pain and muscle weakness (C)</p> Signup and view all the answers

Which of the following conditions is associated with genetic defects in collagen production?

<p>Osteogenesis imperfecta (B)</p> Signup and view all the answers

Which joint is most commonly affected by osteoarthritis?

<p>Knee (B)</p> Signup and view all the answers

Kyphosis can significantly affect which bodily function?

<p>Lung expansion (C)</p> Signup and view all the answers

What is a common non-pharmacological intervention for arthritis pain management?

<p>Cold therapy (C)</p> Signup and view all the answers

What is a common consequence of untreated osteoporosis?

<p>Increased risk of fractures (C)</p> Signup and view all the answers

Symptoms of osteoarthritis often improve with which of the following?

<p>Rest (D)</p> Signup and view all the answers

Which nutritional component is often recommended to support joint health?

<p>Anti-inflammatory foods (B)</p> Signup and view all the answers

What potential adverse effect should be monitored for patients taking OA medications?

<p>Skin integrity issues (C)</p> Signup and view all the answers

Which type of spina bifida is the most common?

<p>Spina bifida occulta (B)</p> Signup and view all the answers

Which of these is NOT a potential symptom of spina bifida occulta?

<p>Hydrocephalus (A)</p> Signup and view all the answers

What is the most severe form of spina bifida?

<p>Spina bifida myelomeningocele (D)</p> Signup and view all the answers

What type of spina bifida involves the protrusion of a fluid-filled sac through the opening in the spine?

<p>Spina bifida meningocele (B)</p> Signup and view all the answers

Which of these conditions is a potential complication of spina bifida myelomeningocele?

<p>All of the above (D)</p> Signup and view all the answers

Which of these is NOT a typical nursing assessment for a patient with spina bifida?

<p>Psychiatric assessment (D)</p> Signup and view all the answers

Which of these is a common laboratory test for a patient with spina bifida?

<p>All of the above (D)</p> Signup and view all the answers

Which of these is NOT a potential nursing intervention for a patient with spina bifida?

<p>Prescribing medication (C)</p> Signup and view all the answers

What is the purpose of maternal serum screening in relation to spina bifida?

<p>To identify women at risk for having a child with spina bifida (D)</p> Signup and view all the answers

Which of these can affect the development and symptoms of spina bifida?

<p>All of the above (D)</p> Signup and view all the answers

Which of these is NOT a potential impact of spina bifida myelomeningocele on a person?

<p>Increased risk for heart disease (C)</p> Signup and view all the answers

What is the primary rationale for performing surgery to repair a sac in spina bifida meningocele?

<p>To prevent infection (C)</p> Signup and view all the answers

What is the most common type of spina bifida that may not cause any symptoms or problems?

<p>Spina bifida occulta (C)</p> Signup and view all the answers

Which of these is NOT a typical complication of spina bifida myelomeningocele?

<p>Pneumonia (C)</p> Signup and view all the answers

What is the primary goal of bladder training for a patient with spina bifida?

<p>To improve bladder control (C)</p> Signup and view all the answers

Which of these is a potential nursing intervention for a patient with spina bifida who is at risk for pressure ulcers?

<p>All of the above (D)</p> Signup and view all the answers

Flashcards

What is Osteoarthritis (OA)?

The breakdown of cartilage and bone in joints, leading to pain, stiffness, and reduced mobility.

What is cartilage?

The protective layer of tissue that covers the ends of bones in joints, allowing for smooth movement.

What is bone sclerosis?

The process by which bone hardens and becomes more dense.

What are bone spurs?

Bony growths that develop around joints, often due to OA.

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What is the joint space?

The space between bones in a joint, which can narrow due to OA.

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What are some common risk factors for OA?

Age, gender, genetics, occupation, obesity, smoking, and injuries.

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What are the common clinical manifestations of OA?

OA is a primary cause of joint pain and stiffness. Its common symptoms include joint pain, stiffness, reduced mobility, crepitus, swelling, tenderness, and bony enlargements.

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What are some diagnostic tests used for OA?

X-ray studies, which show joint space narrowing, subchondral sclerosis, subchondral cysts, and osteophytes.

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What is primary OA?

OA with no clear underlying cause, often related to age, genetics, obesity, and joint stress.

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What is secondary OA?

OA caused by an underlying condition, such as an injury, infection, or metabolic disorder.

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Assessing for Cardiac Involvement

Looking for signs of heart issues like chest pain, irregular heartbeat, shortness of breath, swelling, and bluish skin.

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Assessing for Respiratory Impairment

Checking for breathing problems like shortness of breath, difficulty breathing when lying down, coughing, mucus, wheezing, and crackling sounds.

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Assessing for Gastrointestinal Issues

Assessing for issues like poor appetite, weight changes, trouble with bowel movements, and swelling of the abdomen.

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Assessing for Urinary Concerns

Checking for changes in urination like frequency, urgency, amount, and color, and monitoring overall fluid intake and hydration.

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Assessing for Musculoskeletal Problems

Examining muscle strength, tone, size, and symmetry, as well as posture, gait, balance, and coordination, and checking for pain, spasms, or tightness. Also looking for conditions like curvature of the spine, joint deformities, and pressure sores.

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Osteoporosis

A metabolic bone disease characterized by decreased bone density and increased fracture risk, affecting both the quantity and quality of bone tissue.

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Primary Osteoporosis

A type of osteoporosis that occurs as a result of natural aging, hormonal changes, and genetic factors. It is most common in postmenopausal women and older men.

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Secondary Osteoporosis

A type of osteoporosis caused by another medical condition or medication that affects bone metabolism. It can affect people of any age, sex, or hormonal status.

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Bone Resorption

The process of bone breakdown by specialized cells called osteoclasts.

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RANK (Receptor Activator of Nuclear Factor-κB)

A receptor located on the surface of osteoclast precursors and mature osteoclasts. When activated, it triggers signals that stimulate osteoclast differentiation, activity, and survival, promoting bone resorption.

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RANKL (RANK Ligand)

A protein expressed on the surface of osteoblasts and osteocytes. When RANKL binds to RANK, it triggers osteoclast activation.

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Imbalance in Bone Metabolism

Refers to an imbalance between bone formation and bone resorption, leading to increased bone loss and fracture risk.

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OPG/RANKL/RANK Pathway

The pathway involving RANK, RANKL, and OPG that regulates bone resorption. This pathway is crucial in understanding the mechanisms of osteoporosis.

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Duchenne Muscular Dystrophy

A rare genetic disorder causing progressive muscle weakness and wasting due to lack of dystrophin, a protein vital for muscle integrity.

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What causes Duchenne Muscular Dystrophy?

A gene defect on the X chromosome disrupting the production of dystrophin.

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Clinical Manifestations of Duchenne Muscular Dystrophy

Progressive muscle weakness and atrophy initially affecting legs and pelvis, spreading to arms, neck, and other areas.

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Signs and Symptoms of Duchenne Muscular Dystrophy

Difficulty walking, running, jumping, climbing stairs, frequent falls, waddling gait, enlarged calf muscles, learning disabilities, developmental delays, cardiac and respiratory problems, muscle pain and stiffness, scoliosis.

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Diagnostic Tests for Duchenne Muscular Dystrophy

A detailed medical history, physical examination, blood tests, genetic tests, muscle biopsy, various imaging and electrophysiological studies.

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Nursing Interventions for Duchenne Muscular Dystrophy

There's no cure, but supportive care, medication, surgery, physical, occupational, speech, respiratory, nutritional therapy, assistive devices, education, and support are essential.

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Nursing Assessment for Duchenne Muscular Dystrophy: HISTORY

Asking about family history, onset and progression of symptoms, medications, functional abilities, and quality of life.

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Nursing Assessment for Duchenne Muscular Dystrophy: NEURO

Monitoring level of consciousness, cognitive function, speech, vision, hearing, and cranial nerve function.

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Osteoarthritis

Deterioration of cartilage and bone in a joint, leading to pain, stiffness, and reduced mobility. Usually affects weight-bearing joints like knees and hips.

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Rheumatoid Arthritis

An autoimmune disorder where the immune system attacks the lining of the joints, causing chronic inflammation and damage. Most commonly affects smaller joints like hands, wrists, and feet, but can also affect other organs.

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Osteomalacia

Softening and weakening of bones due to a lack of vitamin D or a defect in its metabolism.

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Osteogenesis Imperfecta

A genetic disorder causing fragile and easily breakable bones due to a defect in collagen production or quality.

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Paget's Disease

A chronic bone disorder characterized by abnormal and disorganized bone structure due to problems with bone remodeling. Can cause bone pain, deformities, arthritis, and nerve compression.

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Nerve Compression or Damage

A condition where a nerve is compressed or damaged, leading to pain, numbness, tingling, or weakness in the affected area.

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Bladder and Bowel Function Changes

Changes in bladder and bowel function, such as difficulty controlling urination or bowel movements.

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Cognitive and Mental Status Changes

Changes in cognitive abilities and mental state, such as memory issues, confusion, or difficulty thinking clearly.

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Vital Signs and Cardiovascular Problems

Evaluation of vital signs, such as heart rate, blood pressure, temperature, and respiratory rate. Also includes assessment of cardiovascular problems like heart murmurs or irregular heartbeat.

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Peripheral Circulation and Skin Color

Check for changes in blood flow to the extremities, such as color changes in the skin, coldness, or swelling.

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Respiratory Function and Problems

Assessment of respiratory function, including breathing rate, ease of breathing, and any signs of respiratory problems like shortness of breath or wheezing.

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Effects of Kyphosis or Osteophytes on Chest Wall and Lung Expansion

Assessment of the effects of kyphosis (curved spine) or osteophytes (bone spurs) on the chest wall and its ability to expand during breathing.

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Nutritional Status and Intake of Anti-inflammatory Foods

Assessment of nutritional status to ensure adequate intake of essential nutrients, especially anti-inflammatory foods.

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Gastrointestinal Problems and Effects of Kyphosis

Assessment of gastrointestinal problems, including digestive issues, constipation, and the effects of kyphosis on the digestive system.

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Spina Bifida

A birth defect that occurs when the spinal column doesn't close completely during pregnancy.

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Spina Bifida Occulta

The most common and mildest form of spina bifida, where the spinal cord is not affected but there is a small gap in one or more vertebrae.

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Spina Bifida Meningocele

A type of spina bifida where a fluid-filled sac protrudes through the opening in the spine, but the spinal cord and nerves are not affected.

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Spina Bifida Myelomeningocele

The most severe form of spina bifida, where the sac contains part of the spinal cord and nerves, leading to potential nerve damage and disabilities.

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Chiari Malformation

A condition that occurs when a portion of the brain tissue extends into the spinal canal.

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Scoliosis

A curved spine, often associated with spina bifida, where the spine is curved to the side.

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Hydrocephalus

A condition where excess fluid builds up in the brain, often associated with spina bifida.

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Tethered Cord Syndrome

A condition that occurs when the spinal cord is tethered to the surrounding tissues, restricting its movement and potentially causing nerve damage.

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Maternal Serum Screening

A prenatal screening test that measures the levels of certain substances in the mother's blood to assess the risk of spina bifida.

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Amniocentesis

A prenatal diagnostic test that involves taking a sample of amniotic fluid to analyze the baby's chromosomes and identify abnormalities.

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Ultrasound

An imaging test used to assess the development of the fetus and detect potential abnormalities.

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Sensory Deficits

A condition that can occur with spina bifida, where there is weakness, numbness, or loss of sensation in the lower extremities.

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Nursing Assessment

A nursing assessment that involves assessing the patient's history, physical exam, and laboratory tests to determine the type and severity of spina bifida.

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Nursing Interventions

A nursing intervention that involves monitoring vital signs, administering medications, and providing comfort care.

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Surgery

A surgical procedure to repair the defect in the spine and close the sac.

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Study Notes

Musculoskeletal System Overview

  • The presentation focused on musculoskeletal topics, including the immobilized client, aging, joint disorders, metabolic bone disease, neuromuscular disorders, and neural tube defects.
  • Objectives included reflecting on anatomy and physiology of the musculoskeletal system, explaining the pathophysiology of related conditions, and reviewing relevant nursing assessments, clinical manifestations, and lab values.

Aging and the Musculoskeletal System

  • Age-related changes in bone structure include reduced bone strength and increased risk of fractures, loss of bone mass and density, and increased joint stiffness and pain.
  • Age-related changes in muscle cause a loss of muscle mass and strength, reduced muscle tone, and decreased endurance and performance.
  • These changes relate to chronic illness and affect height, posture, and mobility.

Factors Affecting Mobility

  • Factors that affect mobility include age, physical health, injuries, nutrition, mental health, environmental factors, medications, lifestyle, personal values, and attitudes.

Physiological Complications of Immobility

  • The presentation discussed potential physiological complications resulting from increased immobility.

Factors Increasing MSK Disorder Risk

  • Intrinsic factors related to individual characteristics include age, gender (women more prone to osteoporosis, rheumatoid arthritis, and fibromyalgia), genetics, and health status (e.g., chronic diseases).
  • Extrinsic factors related to environmental or behavioral influences impacting MSK disorders include lifestyle (smoking, poor nutrition, inactivity, stress), occupation (heavy lifting, repetitive motion, vibration), and exposure to hazards (e.g., falls, trauma).

Understanding Patho from a CJMM Lens

  • The presentation described a process to understand the pathological mechanisms of a condition from a clinical judgment model perspective.
  • Includes recognizing cues, analyzing cues, prioritizing hypotheses, evaluating the clinical judgment model, and generating actions/interventions.
  • Using resources in D2L, the process of diagnosis and pathophysiology are explored.

Disorders of the Joint: Osteoarthritis

  • Osteoarthritis (OA) is a type of arthritis affecting joints, primarily in older people.
  • OA results from cartilage degradation, bone sclerosis, and bone spur formation (osteophytes).
  • It leads to pain, stiffness, and decreased mobility.

OA Pathophysiology

  • OA pathophysiology involves cartilage breakdown, enzyme release, inflammatory factors, and narrowing of joint space, increasing friction between bones.
  • Risk factors include demographic factors (e.g., age, gender, family history) and lifestyle factors (e.g., obesity, smoking, occupation, joint injuries).

OA Cause, Affected Joints, Diagnostic Tests, and Clinical Manifestations

  • OA's primary cause is unknown, affecting many joints, especially the knees, hips, hands, and spine.
  • Diagnosis involves clinical assessment, physical examination, and X-ray studies to detect joint space narrowing, subchondral sclerosis, subchondral cysts, and osteophytes.
  • Clinical manifestations include joint pain, stiffness, reduced mobility worsening with activity, crepitus, swelling, tenderness, and joint deformity.

Nursing Assessment for OA

  • History, neurological, cardiovascular, respiratory, GI, GU, musculoskeletal, and integumentary assessments are crucial.
  • Relevant lab tests evaluate inflammation and rule out secondary causes, monitor medication effects, and assess bone structure/quality.

Metabolic Bone Disease

  • Overview of osteoporosis, osteomalacia, osteogenesis imperfecta, and Paget's disease.
  • Describes loss of bone mass and density, softening/weakening of bones, fragility issues, abnormal bone structure, and chronic remodeling process.

Osteoporosis Pathophysiology

  • A metabolic bone disease that causes bone loss and increases fracture risk, affecting bone quantity and quality (cortical and trabecular).
  • Various hormones influence the development of osteoporosis, including growth hormone, thyroid hormone, parathyroid hormone, and cortisol.

Osteoporosis Primary or Secondary

  • Primary osteoporosis is the most common type, largely affecting postmenopausal women and older men.
  • Secondary osteoporosis is less common, related to medical conditions or medications impacting bone metabolism.

OPG/RANKL/RANK Pathway

  • A pathway involving RANK, RANKL, and OPG, influencing osteoclast activity and bone resorption.

Exacerbating Factors for Secondary Osteoporosis

  • Related to glucocorticoid usage, this has effects on osteoclast survival, osteoblast formation, osteocyte apoptosis, RANKL expression, and reduced OPG production.

Osteoporosis Clinical Manifestations

  • Osteoporosis key symptoms include a dowager's hump, height loss, and back pain, with frequent fractures in the spine, hip, and wrist.

Nursing Assessment for Osteoporosis

  • Includes gathering history, assessing neurological, cardiovascular, respiratory, and other systemic factors, and analyzing lab results.

Neural Tube Defects (Spina Bifida)

  • Describes the pathophysiology, impact on the person, and nursing interventions for different types of spina bifida (occulta, meningocele, myelomeningocele).

Cerebral Palsy

  • Types of cerebral palsy, diagnostic criteria, prevalence, associated impairments, and nursing knowledge.
  • Early diagnosis includes handedness, stiffness, and other developmental and motor delay indicators.

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Description

Test your knowledge on the assessments and interventions related to Duchenne muscular dystrophy. This quiz covers cardiovascular, respiratory, gastrointestinal, and genitourinary aspects as well as specific clinical manifestations and diagnostic tests. Perfect for nursing students and professionals.

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