Podcast
Questions and Answers
Which of the following is a primary characteristic of osteoporosis?
Which of the following is a primary characteristic of osteoporosis?
Which group is statistically more prone to post-menopausal osteoporosis?
Which group is statistically more prone to post-menopausal osteoporosis?
A patient experiencing a stooped posture, loss of height, and backache would most likely have what initial symptom due to osteoporosis?
A patient experiencing a stooped posture, loss of height, and backache would most likely have what initial symptom due to osteoporosis?
Which of the following conditions is characterized by an excessive curve in the upper back?
Which of the following conditions is characterized by an excessive curve in the upper back?
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Which medication is a bone resorption inhibitor, typically taken first thing in the morning with a full glass of water?
Which medication is a bone resorption inhibitor, typically taken first thing in the morning with a full glass of water?
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Besides calcium and Vitamin D, which recommendation can assist with increasing bone density when dealing with osteoporosis?
Besides calcium and Vitamin D, which recommendation can assist with increasing bone density when dealing with osteoporosis?
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A patient presents with a fracture that is characterized by multiple bone fragments. Which type of fracture is this most likely?
A patient presents with a fracture that is characterized by multiple bone fragments. Which type of fracture is this most likely?
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A patient with a fractured tibia develops shortness of breath, chest pain, and petechiae. What complication should the nurse suspect?
A patient with a fractured tibia develops shortness of breath, chest pain, and petechiae. What complication should the nurse suspect?
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A patient has a cast applied to their lower leg following a fracture. Which nursing intervention is most crucial in the first 24-48 hours to prevent complications?
A patient has a cast applied to their lower leg following a fracture. Which nursing intervention is most crucial in the first 24-48 hours to prevent complications?
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A patient with an open fracture is being treated with prophylactic antibiotics. What other intervention is essential to prevent infection?
A patient with an open fracture is being treated with prophylactic antibiotics. What other intervention is essential to prevent infection?
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A patient develops severe pain, numbness, and pallor in their fractured extremity, which is also under a tight cast. This is exhibiting signs of what?
A patient develops severe pain, numbness, and pallor in their fractured extremity, which is also under a tight cast. This is exhibiting signs of what?
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What is the primary goal of a fasciotomy for a patient with compartment syndrome caused by a fracture?
What is the primary goal of a fasciotomy for a patient with compartment syndrome caused by a fracture?
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A patient with a recent diagnosis of osteomyelitis is experiencing increased wound discharge and fever. Which of the following actions should the nurse prioritize?
A patient with a recent diagnosis of osteomyelitis is experiencing increased wound discharge and fever. Which of the following actions should the nurse prioritize?
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Which dietary recommendation is most important for a post-menopausal patient at risk for osteoporosis?
Which dietary recommendation is most important for a post-menopausal patient at risk for osteoporosis?
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A patient is prescribed parathyroid hormone for osteoporosis. What is the maximum duration of treatment for this medication?
A patient is prescribed parathyroid hormone for osteoporosis. What is the maximum duration of treatment for this medication?
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A patient is being discharged following a total knee replacement. Which of the following should the nurse include patient teaching?
A patient is being discharged following a total knee replacement. Which of the following should the nurse include patient teaching?
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A patient with fibromyalgia reports increased pain and stiffness in cold, humid weather. Which of the following lifestyle modifications should the nurse recommend?
A patient with fibromyalgia reports increased pain and stiffness in cold, humid weather. Which of the following lifestyle modifications should the nurse recommend?
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A patient with a hip fracture presents with external leg rotation and a shortened limb. What does the nurse do initially?
A patient with a hip fracture presents with external leg rotation and a shortened limb. What does the nurse do initially?
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Which statement is true concerning the relationship between calcium and phosphorus?
Which statement is true concerning the relationship between calcium and phosphorus?
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A patient post-operative from knee replacement surgery is using a continuous passive motion (CPM) machine. Which nursing intervention is crucial regarding the CPM?
A patient post-operative from knee replacement surgery is using a continuous passive motion (CPM) machine. Which nursing intervention is crucial regarding the CPM?
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Which of the following complications is LEAST likely to result from prolonged immobility?
Which of the following complications is LEAST likely to result from prolonged immobility?
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A patient presents with paresthesia and pulselessness in the affected limb following a fracture repair. According to the 7 Ps assessment, what other findings would warrant immediate concern?
A patient presents with paresthesia and pulselessness in the affected limb following a fracture repair. According to the 7 Ps assessment, what other findings would warrant immediate concern?
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What is the primary purpose of using temporary immobilization such as Buck's Traction before surgical repair?
What is the primary purpose of using temporary immobilization such as Buck's Traction before surgical repair?
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A patient is recovering from a hip replacement. Which of these should the nurse instruct the patient to AVOID to prevent hip dislocation post-operatively?
A patient is recovering from a hip replacement. Which of these should the nurse instruct the patient to AVOID to prevent hip dislocation post-operatively?
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Following an open reduction internal fixation (ORIF) procedure, a patient is typically placed on what weight-bearing status for 6 weeks to 3 months, in most scenarios?
Following an open reduction internal fixation (ORIF) procedure, a patient is typically placed on what weight-bearing status for 6 weeks to 3 months, in most scenarios?
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A patient is 2 days post total hip arthroplasty. Which of the following positions is most important to avoid to prevent hip dislocation?
A patient is 2 days post total hip arthroplasty. Which of the following positions is most important to avoid to prevent hip dislocation?
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What is the primary purpose of an abduction splint for patients recovering from hip replacement surgery?
What is the primary purpose of an abduction splint for patients recovering from hip replacement surgery?
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A nurse is caring for a patient post-operative hip surgery. What is the most appropriate time to administer pain medication in relation to the therapy session?
A nurse is caring for a patient post-operative hip surgery. What is the most appropriate time to administer pain medication in relation to the therapy session?
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A patient is using a trapeze bar post-surgery. What is the primary benefit of this device for the patient?
A patient is using a trapeze bar post-surgery. What is the primary benefit of this device for the patient?
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A client is being discharged home after ORIF of the femur. Which of the following home accommodations should be suggested?
A client is being discharged home after ORIF of the femur. Which of the following home accommodations should be suggested?
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Study Notes
Osteoporosis
- Very brittle bones with potential fractures
- Loss of bone density, impacting vertebral bones, neck of femur, pelvis, hands, and wrists
- Primarily seen in women aged 55-65; linked to estrogen loss
- Common in small-framed, menopausal, white females
- Contributing factors include small frame, menopause, white ethnicity, smoking, caffeine, carbonated beverages, sedentary lifestyle, high protein/sodium/caffeine intake, low calcium/vitamin D/fruits/vegetables, hyperthyroidism, chronic lung disease, alcoholism, smoking, and certain medications (steroids, anticonvulsants, immunosuppressants, heparin)
- Two primary types:
- Juvenile: sudden bone pain, fractures in children and young adults
- Idiopathic: post-menopausal or age-associated
- Post-menopausal: decrease in estrogen after menopause
- Age-associated: decreased bone mass due to aging (typical in 70-85 year olds)
- Initial symptom is often a vertebral fracture, leading to loss of height, stooped posture, backache, and worsened pain during movement.
- Dowager's hump: spinal deformity from repeated vertebral fractures.
- Lordosis: excessive lower back curve.
- Scoliosis: S-shaped spine.
- Kyphosis: excessive upper back curve.
- Diagnosis involves CBC, calcium, phosphorus, BUN, creatinine, urinalysis, thyroid function, DEXA scan, liver function tests, and alkaline phosphatase.
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Cultural Considerations:
- White women have the highest incidence, exceeding Asian and African American women's
- Hispanics and African American women have a lower risk.
- Medical management focuses on increasing bone density:
- Calcium: 1200-2000 mg daily
- Vitamin D: 800 IU daily
- Weight-bearing exercises
- Bone resorption inhibitors (Fosamax, Actonel): first thing in the morning, with water, 30 minutes before food/drinks, and remain upright for 30 minutes afterwards.
- Calcium-rich foods: milk, soy milk, yogurt, cottage cheese, ice cream, sardines (with bones), turnip greens, spinach, calcium-fortified orange juice.
- Vitamin D aids calcium absorption.
- Diet: low sodium, animal protein, and caffeine.
- Selective estrogen receptor modulator (Evista): reduces bone resorption.
- Parathyroid hormone: subcutaneous injection for a maximum of 24 months (for postmenopausal women intolerant to other medications); side effects: orthostatic hypotension, nausea, dizziness, leg cramps, and hypercalcemia.
- Surgical treatment: vertebral augmentation (cement injection into vertebral spaces) and kyphoplasty (less risky balloon injection).
- Nursing interventions: keep patient flat for initial 4 hours, monitor surgical site, administer medications (e.g., antibiotics, steroids).
- Dietary recommendations: high calcium, low sodium, limited animal protein/caffeine.
- Stop smoking if post-menopausal.
- Calcium and Phosphorus have an inverse relationship -high calcium, low phosphorus; high phosphorus, low calcium.
- Post-menopausal hormone replacement therapy (estrogen)
- Safety measures: handrails, raised toilet seats, weight-bearing exercises (at least 3 times a week).
Osteomyelitis
- Inflammation of bone from pathogenic bacteria.
- Common causes: trauma, bacteria traveling via bloodstream to weakened bone.
- Staphylococcus aureus is most common, followed by Streptococcus and E. coli.
- Treatment: antibiotics, hyperbaric oxygen therapy, and sometimes surgery.
- Wound care is essential: antibiotics, hyperbaric oxygen, wound irrigation, contact precautions, monitoring infection worsening.
- Complications: amputation, pathologic fractures, chronic osteomyelitis.
- Surgery: necrotic bone removal, pus drainage, sequestrum removal (dead bone tissue).
- Hyperbaric oxygen stimulates tissue growth and repair.
- Long-term antibiotic therapy (3-6 months).
- Diagnostic tests: MRI, CT, CBC, ESR, CRP, needle aspiration, cultures.
Fibromyalgia
- Chronic syndrome with unknown cause (etiology).
- Characterized by muscle, bone, or joint pain, soft tissue tenderness, and neck/lower back issues.
- Associated symptoms: poor sleep, headaches, altered thought processes, stiffness, muscle aches, depression, and anxiety.
- More common in women (20-50 years old).
- Other symptoms: tension/migraine headaches, paresthesia, painful periods, forgetfulness, persistent limb movements.
- Aggravated by cold/humid weather, physical/mental fatigue, excessive activity, anxiety, or stress.
- No cure; diagnosed by ruling out other conditions (may take months to years).
- Treatment involves tricyclic antidepressants, anticonvulsants, muscle relaxants, analgesics (Tylenol, NSAIDs), and WPI assessment (widespread pain index).
- WPI: measures pain in 19 areas for diagnosis assistance.
- Interventions: non-impact exercise (stretching, swimming, walking, stationary bike, yoga), stress reduction, and sleep hygiene (avoid large meals before bed, dark/quiet room, regular schedule, limited naps, avoid nicotine/alcohol/caffeine).
Knee Replacement
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Hip Fracture
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Fractures
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Nursing Interventions for Fractures
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Fractures Complication: Fat Embolism
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Fractures Complication: Compartment Syndrome
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Fractures Complication: Shock
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Fractures Complication: Gas Gangrene
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Fractures Complication: Thromboembolism
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External Fixation Devices
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Description
This quiz provides an in-depth overview of osteoporosis, detailing its impact on bone density and specific risk factors associated with the condition. It covers demographic details, types of osteoporosis, and lifestyle factors that increase the risk. Test your knowledge on this critical health issue that primarily affects women as they age.
