Clinical Judgement Final
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Questions and Answers

Which of the following contributes to bone loss in osteoporosis?

  • Greater bone resorption than rebuilding (correct)
  • Decreased osteoclast activity
  • Enhanced mineral density
  • Increased osteoblast activity

What percentage of women are likely to sustain an osteoporotic fracture after menopause?

  • 75%
  • 25%
  • 40%
  • 50% (correct)

Which of the following is NOT considered a primary risk factor for osteoporosis?

  • Cushing's disease (correct)
  • Family history of osteoporosis
  • Age over 50
  • Being female

What diagnostic tool is primarily used to assess bone mineral density in osteoporosis?

<p>Dual-energy x-ray absorptiometry (DEXA) scan (B)</p> Signup and view all the answers

Which condition is associated with increased risk of osteoporosis due to hormonal factors?

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

What type of scan is primarily used to assess bone density?

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

Which of the following conditions is associated with an increased risk of fractures due to weakened bones?

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

Which video specifically discusses the differences between Tylenol and NSAIDs?

<p>Tylenol vs NSAIDs (A)</p> Signup and view all the answers

What is the main focus of the video titled 'Living with Paget's – Mickey's Story'?

<p>Patient experiences with Paget's Disease (C)</p> Signup and view all the answers

Which organization provides information regarding the DEXA scan and its purpose?

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

Which medication class is associated with promoting calcium reabsorption but also has risks such as blood clots?

<p>Selective Estrogen Receptor Modulators (SERMs) (B)</p> Signup and view all the answers

What common clinical manifestation suggests decreased bone density that may lead to mobility issues?

<p>Dowager's hump (C)</p> Signup and view all the answers

Which of the following nursing diagnoses is most directly related to the risk of falls in patients with Paget's disease?

<p>Risk for trauma (A)</p> Signup and view all the answers

What is the recommended daily exposure to sunlight for adequate vitamin D synthesis?

<p>15 minutes (B)</p> Signup and view all the answers

Which of the following medications is a first-line treatment for Paget's disease?

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

What is a significant complication associated with prolonged hospitalization in patients with Paget's disease?

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

Which lifestyle choice is recommended to help manage Paget's disease effectively?

<p>Healthy lifestyle choices (A)</p> Signup and view all the answers

What is a key nursing intervention to evaluate care outcomes for patients with Paget's disease?

<p>Identify risk for osteoporosis (C)</p> Signup and view all the answers

What is a significant risk factor for the development of carpal tunnel syndrome?

<p>Reduced circulation due to diabetes (B)</p> Signup and view all the answers

Which gender has a higher prevalence of carpal tunnel syndrome?

<p>Females are more likely (B)</p> Signup and view all the answers

Which clinical manifestation is NOT typically associated with carpal tunnel syndrome?

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

Which diagnostic test is used to assess nerve conduction in carpal tunnel syndrome?

<p>Nerve conduction studies (EMG) (D)</p> Signup and view all the answers

What is a common surgical approach for treating severe carpal tunnel syndrome?

<p>Endoscopic carpal tunnel release (D)</p> Signup and view all the answers

Which intervention is NOT recommended for managing symptoms of carpal tunnel syndrome?

<p>Physical activity increase (B)</p> Signup and view all the answers

What can result from untreated carpal tunnel syndrome?

<p>Chronic pain and immobility (B)</p> Signup and view all the answers

Which nursing diagnosis is appropriate for a patient with carpal tunnel syndrome?

<p>Impaired physical mobility (B)</p> Signup and view all the answers

What primary consequence does increased osteoclast activity have in patients with the bone metabolism disorder described?

<p>Accelerated bone resorption (A)</p> Signup and view all the answers

Which population is most commonly affected by the bone metabolism disorder?

<p>White adult males over 55 (C)</p> Signup and view all the answers

Which symptom is NOT typically associated with advanced disease in the bone metabolism disorder?

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

Which medication is preferred for managing the bone metabolism disorder?

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

Which factor is a suggested environmental trigger for the bone metabolism disorder?

<p>Infection with measles virus (A)</p> Signup and view all the answers

What key laboratory finding is associated with the bone metabolism disorder diagnosis?

<p>Increased serum alkaline phosphatase (B)</p> Signup and view all the answers

Which of the following is a recognized risk factor for the bone metabolism disorder?

<p>History of measles (A)</p> Signup and view all the answers

Which of the following nursing diagnoses is applicable to patients with the bone metabolism disorder?

<p>Risk for trauma (C)</p> Signup and view all the answers

In managing pain for the bone metabolism disorder, which med is used last due to side effects?

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

Which complication is possible in patients with this bone metabolism disorder?

<p>Development of osteosarcoma (D)</p> Signup and view all the answers

What primarily causes hyperuricemia in patients with gout?

<p>Excessive production of uric acid (A)</p> Signup and view all the answers

Which of the following demographic groups is noted to have the highest incidence of gout?

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

What symptom is most characteristic of an acute gout attack?

<p>Intense pain with redness and swelling (D)</p> Signup and view all the answers

Which medication is specifically used to lower uric acid production in chronic gout management?

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

What dietary consideration can significantly help in managing gout?

<p>Limiting alcohol, especially beer (A)</p> Signup and view all the answers

What complications can arise from untreated gout?

<p>Kidney stones and joint deformity (B)</p> Signup and view all the answers

Which nursing intervention should be avoided to help manage gout effectively?

<p>Using ice packs on the affected area (B)</p> Signup and view all the answers

In the context of gout, what does the term 'tophi' refer to?

<p>Uric acid deposits in joints or soft tissues (D)</p> Signup and view all the answers

What non-pharmacologic treatment is recommended for managing gout?

<p>Weight management and dietary restrictions (A)</p> Signup and view all the answers

What is the primary method for diagnosing gout?

<p>Synovial fluid aspiration to identify uric acid crystals (B)</p> Signup and view all the answers

What is the primary goal of glaucoma treatment?

<p>To maintain normal intraocular pressure (IOP) (C)</p> Signup and view all the answers

Which medication class is considered first-line for acute angle-closure glaucoma?

<p>Carbonic anhydrase inhibitors (D)</p> Signup and view all the answers

What is a common clinical manifestation of both open angle glaucoma and acute angle-closure glaucoma?

<p>Progressive peripheral vision loss (A)</p> Signup and view all the answers

Which of the following is typically NOT a symptom associated with acute angle-closure glaucoma?

<p>Mild eye pain (B)</p> Signup and view all the answers

What is the significance of maintaining intraocular pressure within the range of 10 to 21 mm Hg in glaucoma patients?

<p>It protects against damage to the optic nerve (D)</p> Signup and view all the answers

What is the primary action of timolol in the treatment of glaucoma?

<p>Decrease intraocular pressure (C)</p> Signup and view all the answers

Which surgical method involves creating an opening in the sclera for aqueous humor drainage?

<p>Filtering surgery/trabeculectomy (B)</p> Signup and view all the answers

Which of the following nursing interventions is NOT appropriate for managing increased intraocular pressure?

<p>Encourage bending at the waist (A)</p> Signup and view all the answers

What is the purpose of inserting a drainage implant during surgical management of glaucoma?

<p>To facilitate the drainage of aqueous humor (A)</p> Signup and view all the answers

Which nursing diagnosis is most likely associated with a patient suffering from glaucoma?

<p>Disturbed visual sensory perception (B)</p> Signup and view all the answers

What significant symptom should be monitored postoperatively in patients undergoing glaucoma surgery?

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

Which of the following statements about progressive glaucoma is true?

<p>It may lead to irreversible peripheral vision loss. (A)</p> Signup and view all the answers

Which nursing intervention is critical for patients with increased intraocular pressure?

<p>Teaching proper eye drop technique (A)</p> Signup and view all the answers

What is the primary characteristic of glaucoma concerning intraocular pressure (IOP)?

<p>IOP greater than 21 mm Hg can cause optic nerve damage (B)</p> Signup and view all the answers

Which mechanism can cause increased intraocular pressure in glaucoma?

<p>Inadequate drainage from the canal of Schlemm (D)</p> Signup and view all the answers

Which type of glaucoma is a medical emergency?

<p>Angle-closure glaucoma (D)</p> Signup and view all the answers

Which of the following demographics is at the highest risk for developing normal-tension glaucoma?

<p>Individuals of Japanese ancestry with family history (D)</p> Signup and view all the answers

What relationship exists between aqueous humor outflow and glaucoma development?

<p>Inhibited outflow results in increased IOP and optic nerve damage (B)</p> Signup and view all the answers

Which of the following substances is directly linked to an increased risk of cataracts?

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

What is the primary symptom that distinguishes cataracts from other vision problems?

<p>Painless blurry vision (A)</p> Signup and view all the answers

At what age does the prevalence of cataracts notably rise among the American population?

<p>80 years old (A)</p> Signup and view all the answers

What is a significant potential complication of cataract surgery?

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

Which method is primarily used for diagnosing cataracts?

<p>Visual acuity test (A)</p> Signup and view all the answers

Which nursing intervention is essential in the postoperative care of a patient after cataract surgery?

<p>Administer stool softeners (A)</p> Signup and view all the answers

Which of the following is NOT typically considered a risk factor for cataracts?

<p>History of strokes (C)</p> Signup and view all the answers

Which clinical manifestation can be a sign of cataracts?

<p>Night vision difficulty (D)</p> Signup and view all the answers

In terms of family history, which statement is true regarding cataracts?

<p>It is hereditary and can be linked to certain ethnicities (C)</p> Signup and view all the answers

Which intervention can help reduce the risk factors associated with cataracts?

<p>Wear UV protection sunglasses (B)</p> Signup and view all the answers

Which type of conjunctivitis is characterized by clear watery discharge?

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

What is the primary purpose of treating bacterial conjunctivitis with antibiotic drops?

<p>To kill the causative bacterial agents (D)</p> Signup and view all the answers

Which of the following is a common clinical manifestation associated with mechanical conjunctivitis?

<p>Presence of a foreign body in the eye (A)</p> Signup and view all the answers

Which factor does NOT contribute to the risk of developing conjunctivitis?

<p>Engaging in routine eye exams (A)</p> Signup and view all the answers

What is the typical treatment approach for viral conjunctivitis?

<p>Comfort measures and cold compresses (B)</p> Signup and view all the answers

In the context of nursing diagnoses for patients with conjunctivitis, which diagnosis is highly relevant?

<p>Risk for infection transmission (B)</p> Signup and view all the answers

Which organism is identified as the most common cause of bacterial conjunctivitis?

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

Which nursing intervention is crucial for managing patients with conjunctivitis effectively?

<p>Providing education on transmission prevention (B)</p> Signup and view all the answers

Which discharge characteristic is most indicative of bacterial conjunctivitis?

<p>Green or yellow pus-like discharge (A)</p> Signup and view all the answers

Which of the following is a common strategy to decrease the incidence of HEENT disorders like conjunctivitis?

<p>Practicing good hygiene (B)</p> Signup and view all the answers

What leads to irreversible central vision loss in macular degeneration?

<p>Deterioration of the macular area of the retina (D)</p> Signup and view all the answers

Which type of macular degeneration is characterized by the accumulation of drusen beneath the retina?

<p>Dry macular degeneration (B)</p> Signup and view all the answers

What is a common early symptom of macular degeneration?

<p>Wavy distortion of straight lines (C)</p> Signup and view all the answers

Which of the following is a primary risk factor for developing macular degeneration?

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

Which approach is used to diagnose wet macular degeneration?

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

What treatment is typically recommended for dry macular degeneration?

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

Which statement is true about wet macular degeneration?

<p>It typically leads to a quick loss of central vision. (B)</p> Signup and view all the answers

Which of the following factors does NOT increase the risk of macular degeneration?

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

What visual effect is often associated with the progression of dry macular degeneration?

<p>Diminished or changed color perception (B)</p> Signup and view all the answers

What is the first-line treatment for wet macular degeneration?

<p>Injections of anti-VEGF therapy (C)</p> Signup and view all the answers

Which of the following is a notable clinical manifestation of wet macular degeneration?

<p>Rapid loss of central vision (B)</p> Signup and view all the answers

What dietary change is suggested for those at risk of macular degeneration?

<p>Eat foods high in beta-carotene (D)</p> Signup and view all the answers

Which of the following is a critical step in the nursing management of patients with macular degeneration?

<p>Regularly testing visual acuity (D)</p> Signup and view all the answers

What complication can arise from untreated macular degeneration?

<p>Severe irreversible vision loss (C)</p> Signup and view all the answers

Which of the following medications is considered a part of the medical management for Alzheimer's disease?

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

What nursing diagnosis would be appropriate when considering the challenges faced by caregivers of Alzheimer's patients?

<p>Caregiver role strain (A)</p> Signup and view all the answers

Which assessment is crucial for evaluating an Alzheimer's patient's safety in their environment?

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

Which intervention is recommended to support the emotional needs of a patient with Alzheimer's disease?

<p>Provide routine activities (B)</p> Signup and view all the answers

What outcome is a primary focus when evaluating care for patients with Alzheimer's disease?

<p>Enhanced quality of life (C)</p> Signup and view all the answers

Which nursing intervention is essential for promoting safety in patients with Parkinson's Disease?

<p>Implement safety precautions (A)</p> Signup and view all the answers

What is considered one of the most common clinical manifestations of Alzheimer’s Disease?

<p>Short-term memory problems (D)</p> Signup and view all the answers

Which of the following is a key aspect of nursing management when evaluating care outcomes for patients with dementia?

<p>Prevention of falls (C)</p> Signup and view all the answers

Which group is recognized to have a higher prevalence of Alzheimer’s Disease?

<p>Women over 65 (D)</p> Signup and view all the answers

In the context of nursing interventions for Parkinson’s Disease, what is an important teaching element for patients?

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

What factor is associated with the risk of developing Alzheimer’s Disease?

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

How is Alzheimer’s Disease primarily diagnosed, given there is no definitive test?

<p>Based on clinical history and physical examination (A)</p> Signup and view all the answers

Which of the following best describes the primary pathophysiological change in Parkinson's disease?

<p>Loss of dopamine-producing brain cells (A)</p> Signup and view all the answers

Which neurotransmitter change is noted in the pathophysiology of Alzheimer’s Disease?

<p>Decrease in neurotransmitters (C)</p> Signup and view all the answers

Which of the following is a cardinal symptom that must be present for a diagnosis of Parkinson's disease?

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

What is a common nursing diagnosis for patients with Parkinson's disease?

<p>Risk for falls (B)</p> Signup and view all the answers

Which of the following nursing interventions is appropriate for assessing patients with Parkinson's disease?

<p>Assess bowel and bladder function (A)</p> Signup and view all the answers

What medication class is commonly prescribed to manage the symptoms of Parkinson's disease?

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

Which of the following clinical manifestations is NOT typically associated with Parkinson's disease?

<p>Acute chest pain (B)</p> Signup and view all the answers

What demographic trend is observed in the epidemiology of Parkinson's disease?

<p>Higher prevalence in males than females (C)</p> Signup and view all the answers

Which of the following statements regarding the management of Parkinson's disease is correct?

<p>Management encompasses both medical and nursing interventions (C)</p> Signup and view all the answers

What differentiates open-angle glaucoma from closed-angle glaucoma?

<p>Open-angle glaucoma occurs with a gradual pressure build-up, while closed-angle has a blocked drainage angle. (D)</p> Signup and view all the answers

Which statement accurately reflects the symptoms associated with closed-angle glaucoma?

<p>Patients may experience eye pain and blurred vision. (B)</p> Signup and view all the answers

What potential consequence can occur if open-angle glaucoma is left untreated?

<p>Permanent damage to the optic nerve leading to blindness. (C)</p> Signup and view all the answers

In what way do the drainage mechanisms for open-angle and closed-angle glaucoma differ?

<p>Open-angle glaucoma's drainage is open but inefficient, while closed-angle has a physical blockage. (A)</p> Signup and view all the answers

Which population is more likely to experience closed-angle glaucoma compared to open-angle glaucoma?

<p>People at older ages and those with anatomical predispositions. (C)</p> Signup and view all the answers

Which clinical manifestation is specific to acute angle-closure glaucoma?

<p>Colored halos around lights (D)</p> Signup and view all the answers

Which medication class is primarily used to reduce aqueous fluid production in glaucoma management?

<p>Carbonic anhydrase inhibitors (D)</p> Signup and view all the answers

What is the primary goal of glaucoma treatment regarding intraocular pressure (IOP)?

<p>To maintain IOP between 10 to 21 mm Hg (D)</p> Signup and view all the answers

In the context of acute angle-closure glaucoma, which symptom would likely indicate an urgent condition?

<p>Severe pain and nausea (B)</p> Signup and view all the answers

Which medication is preferred as a first-line treatment for chronic open-angle glaucoma?

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

What mechanism primarily leads to increased intraocular pressure (IOP) in glaucoma?

<p>Excessive production of aqueous humor (B)</p> Signup and view all the answers

Which group is considered to be at higher risk for developing normal-tension glaucoma?

<p>Individuals of Japanese ancestry with heart disease (D)</p> Signup and view all the answers

What is considered a defining feature of angle-closure glaucoma compared to open-angle glaucoma?

<p>Narrowing of the angle between the iris and cornea (A)</p> Signup and view all the answers

Which of the following is NOT a recognized risk factor for glaucoma?

<p>High levels of physical activity (B)</p> Signup and view all the answers

Which statement is accurate regarding the drainage system's role in the pathophysiology of glaucoma?

<p>It must remain intact for normal aqueous humor outflow. (A)</p> Signup and view all the answers

What is a primary risk factor that promotes the transmission of conjunctivitis?

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

Which of the following is NOT a common clinical manifestation of bacterial conjunctivitis?

<p>Clear watery discharge (B)</p> Signup and view all the answers

How should allergic conjunctivitis be primarily treated?

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

Which of the following conditions would most likely require antibiotic treatment?

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

Which of the following assessment findings might suggest a patient is experiencing photophobia due to conjunctivitis?

<p>Pain in the eye (D)</p> Signup and view all the answers

Which form of conjunctivitis is linked to the presence of foreign bodies in the eye?

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

Which type of conjunctivitis is most frequently seen in epidemic outbreaks?

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

What is a key nursing diagnosis for patients with conjunctivitis?

<p>Risk for infection transmission (D)</p> Signup and view all the answers

Which statement about the treatment of viral conjunctivitis is accurate?

<p>No treatment is necessary as it should resolve on its own. (D)</p> Signup and view all the answers

Which of the following is a common environmental factor contributing to cataract development?

<p>UV light exposure (C)</p> Signup and view all the answers

What is the most effective treatment for cataracts once they have developed?

<p>Surgical removal of the opaque lens (A)</p> Signup and view all the answers

Which demographic is slightly more likely to develop cataracts?

<p>Women over 50 years (A)</p> Signup and view all the answers

What symptom might indicate a serious complication after cataract surgery that requires immediate medical attention?

<p>Light flashes and floaters (D)</p> Signup and view all the answers

Which vision change is NOT typically associated with cataracts?

<p>Complete loss of vision (B)</p> Signup and view all the answers

What nursing diagnosis might be applicable for a patient with cataracts experiencing difficulty seeing at night?

<p>Risk for falls (A)</p> Signup and view all the answers

Which method is used to assess the opacity of the lens when diagnosing cataracts?

<p>Direct ophthalmoscope examination (B)</p> Signup and view all the answers

What condition is represented by the clinical manifestation of an absent red light reflex?

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

Which of the following statements about cataracts is FALSE?

<p>Cataracts typically develop into painful conditions. (C)</p> Signup and view all the answers

Which risk factor is known to double the likelihood of developing cataracts?

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

What is a characteristic feature of Ménière's Disease related to hearing loss?

<p>Fluctuating unilateral sensorineural hearing loss (B)</p> Signup and view all the answers

What is one potential risk factor for developing Ménière's Disease?

<p>History of recent viral illness (B)</p> Signup and view all the answers

Which symptom is most likely to increase in severity with sudden movements in a patient with Ménière's Disease?

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

What type of dietary approach is recommended for patients with Ménière's Disease?

<p>Low-sodium diet (C)</p> Signup and view all the answers

What is a common medical management approach for treating symptoms of Ménière's Disease?

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

Which surgical intervention may result in complete hearing loss for patients with Ménière's Disease?

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

Which demographic is most affected by Ménière's Disease?

<p>Individuals of white or European descent, aged 40-60 (D)</p> Signup and view all the answers

What type of clinical test is often used to evaluate balance issues in patients suspected of having Ménière's Disease?

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

What is the primary pathological feature associated with Ménière's Disease?

<p>Excess endolymphatic fluid (B)</p> Signup and view all the answers

Which of the following is not a common clinical manifestation of Ménière's Disease?

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

What is the primary cause of age-related macular degeneration (AMD)?

<p>Accumulation of cellular waste in the macula (A)</p> Signup and view all the answers

What distinguishes wet macular degeneration from dry macular degeneration?

<p>Rapid loss of central vision (B)</p> Signup and view all the answers

Which of the following is a modifiable risk factor for developing macular degeneration?

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

What is the first symptom commonly associated with macular degeneration?

<p>Distorted straight lines (B)</p> Signup and view all the answers

Which treatment is used for wet macular degeneration?

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

Which form of macular degeneration typically leads to the development of the other?

<p>Dry macular degeneration leads to wet macular degeneration (D)</p> Signup and view all the answers

What is the purpose of the Amsler grid in managing macular degeneration?

<p>To detect distortion in central vision (D)</p> Signup and view all the answers

Which treatment is NOT typically recommended for dry macular degeneration?

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

Which clinical manifestation is associated with wet macular degeneration?

<p>Quick loss of central vision (B)</p> Signup and view all the answers

What is the goal of medical management for patients with macular degeneration?

<p>Preservation of existing vision (A)</p> Signup and view all the answers

Which of the following best describes the progression of symptoms in dry macular degeneration?

<p>There is gradual blurring of central vision (D)</p> Signup and view all the answers

Which dietary change is recommended for managing risk factors of macular degeneration?

<p>Incorporating foods rich in omega-3s (B)</p> Signup and view all the answers

What is a common complication associated with untreated macular degeneration?

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

Which statement is true regarding the demographic impact of macular degeneration?

<p>The risk significantly increases after age 75 (D)</p> Signup and view all the answers

What characterizes osteoarthritis as a disease process?

<p>Progressive deterioration of articular cartilage (C)</p> Signup and view all the answers

Which of the following best describes the pathophysiological changes observed in osteoarthritis?

<p>Uneven joint surfaces and thickening of the synovial membrane (A)</p> Signup and view all the answers

How does muscle atrophy affect patients with osteoarthritis?

<p>It contributes to joint pain and further restricts movement. (D)</p> Signup and view all the answers

What is the primary epidemiological consideration regarding osteoarthritis in the U.S.?

<p>It is the most prevalent form of arthritis among adults. (D)</p> Signup and view all the answers

Which nursing intervention is most appropriate for managing a patient with a deteriorating condition related to osteoarthritis?

<p>Implementing weight management strategies to reduce joint stress. (A)</p> Signup and view all the answers

Which surgical procedure aims to remove the inflamed synovial tissue in joint disorders?

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

What is a common complication associated with decreased mobility due to joint disorders?

<p>Worsening cardiovascular function (B)</p> Signup and view all the answers

What assessment finding might indicate potential kidney dysfunction in a patient using NSAIDs?

<p>Elevated serum creatinine (D)</p> Signup and view all the answers

Which nursing intervention is crucial for monitoring liver function in patients on long-term medication regimens?

<p>Liver function tests (LFTs) (A)</p> Signup and view all the answers

Which aspect of nursing intervention is critical in promoting patient safety related to surgical management?

<p>Monitoring for pressure ulcers (A)</p> Signup and view all the answers

What is a primary goal in the management of osteoarthritis?

<p>Decrease pain and maintain mobility (C)</p> Signup and view all the answers

Which of the following factors is NOT considered a risk factor for osteoarthritis?

<p>Increased physical activity (B)</p> Signup and view all the answers

Which joints are most commonly affected by osteoarthritis?

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

What laboratory markers are typically associated with osteoarthritis diagnosis?

<p>Normal ESR and CRP levels (A)</p> Signup and view all the answers

What is a common clinical manifestation of osteoarthritis?

<p>Progressive pain that is relieved by rest (B)</p> Signup and view all the answers

Which diagnostic method is particularly useful for assessing bone mineral density?

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

What is a critical consideration when managing symptoms of gout?

<p>Hydration and fluid intake (A)</p> Signup and view all the answers

What is the primary characteristic of Paget's disease?

<p>Increased bone pain and deformity (A)</p> Signup and view all the answers

Which among the following is a common complication associated with osteoporosis?

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

Which of the following is NOT a primary source of information regarding DEXA scans?

<p>Youtube tutorial videos (A)</p> Signup and view all the answers

What primary factor contributes to the development of osteopenia?

<p>Decreased bone mineral density due to resorption (C)</p> Signup and view all the answers

Which of the following factors is NOT classified as a secondary risk factor for osteoporosis?

<p>Family history of osteoporosis (D)</p> Signup and view all the answers

What is the primary reason osteoporosis is referred to as a 'silent disease'?

<p>Symptoms occur only after a fracture (C)</p> Signup and view all the answers

Which diagnostic method is used to rule out secondary causes of osteoporosis?

<p>Lab tests for metabolic bone disorders (B)</p> Signup and view all the answers

What percentage of patients over the age of 50 will experience an osteoporotic fracture as a result of decreased bone density?

<p>50% (B)</p> Signup and view all the answers

Which characteristic is most directly linked to Paget's disease of bone?

<p>Disorganized and brittle structure of the bone (C)</p> Signup and view all the answers

What is the primary goal of medical management for Paget's disease?

<p>Pain management and functional improvement (C)</p> Signup and view all the answers

Which imaging technique is most essential in diagnosing Paget's disease?

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

Which demographic is most commonly affected by the bone metabolism disorder discussed?

<p>Older males of European descent (C)</p> Signup and view all the answers

What complication is associated with advanced Paget's disease affecting neurological function?

<p>Loss of bladder/bowel control (D)</p> Signup and view all the answers

Which medication is commonly used but may develop resistance over time in managing Paget's disease?

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

Which laboratory finding is indicative of Paget's disease?

<p>Elevated serum alkaline phosphatase (D)</p> Signup and view all the answers

Which nursing diagnosis specifically addresses the potential for physical injury in patients with Paget's disease?

<p>Risk for trauma (A)</p> Signup and view all the answers

What common symptom may indicate advanced Paget's disease affecting bone structure?

<p>Deformity at the affected bony site (A)</p> Signup and view all the answers

Which intervention is focused on maintaining patient safety in Paget's disease management?

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

What is the primary treatment approach for Dry Macular Degeneration?

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

Which statement accurately describes a characteristic of Wet Macular Degeneration?

<p>It results from the growth of abnormal blood vessels under the retina. (A)</p> Signup and view all the answers

Which treatment is NOT associated with Wet Macular Degeneration?

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

What is the result of impaired blood supply in Dry Macular Degeneration?

<p>Gradual loss of central vision (B)</p> Signup and view all the answers

Which of the following best describes the vision loss experienced in Wet Macular Degeneration?

<p>Rapid and often irreversible (D)</p> Signup and view all the answers

Which of the following conditions is characterized by episodes of vertigo, hearing loss, and tinnitus?

<p>Menière's Disease (D)</p> Signup and view all the answers

What is the primary cause of vision loss in patients suffering from untreated glaucoma?

<p>Optic nerve damage (B)</p> Signup and view all the answers

Which lifestyle modification is least likely to benefit patients with Menière's Disease?

<p>Participating in high-impact sports (D)</p> Signup and view all the answers

Which treatment strategy is most effective in managing acute angle-closure glaucoma?

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

What is the primary role of the cochlea in the inner ear?

<p>Sound wave transduction (A)</p> Signup and view all the answers

Which type of glaucoma is considered a medical emergency due to the rapid onset of symptoms?

<p>Angle-closure glaucoma (D)</p> Signup and view all the answers

Which mechanism is NOT associated with the increased intraocular pressure (IOP) seen in glaucoma?

<p>Overhydration of corneal cells (B)</p> Signup and view all the answers

Which demographic factors are most associated with a higher risk of developing normal-tension glaucoma?

<p>Individuals of Japanese ancestry with heart disease (B)</p> Signup and view all the answers

What is the defining characteristic of primary open-angle glaucoma compared to other types?

<p>It progresses silently without symptoms in early stages (C)</p> Signup and view all the answers

Which of the following conditions is NOT a typical risk factor for developing glaucoma?

<p>High levels of physical activity (B)</p> Signup and view all the answers

What is the primary cause of the clouding in the eye's crystalline lens associated with cataracts?

<p>Continual growth of lens protein fibers (C)</p> Signup and view all the answers

Which of the following is NOT a common clinical manifestation of cataracts?

<p>Increased peripheral vision (C)</p> Signup and view all the answers

What surgical procedure is considered the most effective treatment for cataracts?

<p>Surgical removal of the opaque lens (B)</p> Signup and view all the answers

Which risk factor is specifically indicated to double the likelihood of developing cataracts?

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

What is a potential complication of cataract surgery that requires immediate medical attention?

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

What clinical manifestation indicates a retinal detachment?

<p>Light flashes in the visual field (A)</p> Signup and view all the answers

Which nursing diagnosis is most pertinent for a patient suffering from cataracts?

<p>Disturbed visual sensory perception (B)</p> Signup and view all the answers

Which of the following assessments is NOT typically performed to diagnose cataracts?

<p>CT scan of the eye (C)</p> Signup and view all the answers

What lifestyle change can help in decreasing the risk factors associated with cataracts?

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

Which statement about the demographic impact of cataracts is accurate?

<p>More than half of Americans over 80 years old are affected. (A)</p> Signup and view all the answers

What common characteristic is shared by both bacterial and allergic conjunctivitis?

<p>Itching of the eyes (B)</p> Signup and view all the answers

Which of the following is a primary nursing diagnosis for a patient with conjunctivitis?

<p>Risk for infectious transmission (C)</p> Signup and view all the answers

Which type of conjunctivitis is most likely caused by a viral infection?

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

What is a common treatment approach for allergic conjunctivitis?

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

Which of the following organisms is typically associated with bacterial conjunctivitis?

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

In the management of conjunctivitis, what action is important to prevent infection spread?

<p>Educating patient on hand hygiene (C)</p> Signup and view all the answers

What symptom is indicative of chemical conjunctivitis?

<p>Redness with necrosis of conjunctiva (A)</p> Signup and view all the answers

Which risk factor significantly increases the chance of developing conjunctivitis?

<p>Improper contact lens hygiene (D)</p> Signup and view all the answers

What is the recommended nursing intervention for a patient experiencing photophobia due to conjunctivitis?

<p>Provide sunglasses to minimize light exposure (D)</p> Signup and view all the answers

What is the most common cause of viral conjunctivitis?

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

What is a common reversible treatment for dry macular degeneration?

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

Which symptom is typically associated with wet macular degeneration?

<p>Quick loss of central vision (C)</p> Signup and view all the answers

What is considered a nonmodifiable risk factor for macular degeneration?

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

Which treatment specifically targets the leaky blood vessels in wet macular degeneration?

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

How does macular degeneration primarily affect vision?

<p>It leads to irreversible central vision loss. (C)</p> Signup and view all the answers

What medical examination is vital for assessing macular degeneration?

<p>Comprehensive eye examination (B)</p> Signup and view all the answers

Which dietary recommendation is beneficial for reducing the risk of macular degeneration?

<p>Vitamins A, C, E, and Omega-3s (B)</p> Signup and view all the answers

What does the acronym VEGF stand for in the context of wet macular degeneration?

<p>Vascular Endothelial Growth Factor (D)</p> Signup and view all the answers

What is typically the initial indicator that a patient may have macular degeneration?

<p>Wavy appearance of straight lines (A)</p> Signup and view all the answers

In managing wet macular degeneration, which of the following treatments is NOT typically utilized?

<p>High-dose beta-carotene (A)</p> Signup and view all the answers

Which clinical symptom is NOT commonly associated with dry macular degeneration?

<p>Rapid vision loss (B)</p> Signup and view all the answers

What type of vision loss is primarily experienced by individuals with macular degeneration?

<p>Central vision loss (D)</p> Signup and view all the answers

Which of the following is a primary goal in managing macular degeneration?

<p>Maintain and preserve remaining vision (B)</p> Signup and view all the answers

What is a common misconception about macular degeneration?

<p>It can be completely cured. (C)</p> Signup and view all the answers

What is a common method used to evaluate the balance system in patients suspected of having Ménière's Disease?

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

Which symptom is NOT commonly associated with Ménière's Disease?

<p>Bilateral hearing loss (A)</p> Signup and view all the answers

Which dietary recommendation is often suggested to help manage Ménière's Disease?

<p>Low-sodium diet (A)</p> Signup and view all the answers

What is one possible surgical intervention for managing severe Ménière's Disease?

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

Which patient factor is NOT considered a risk factor for the development of Ménière's Disease?

<p>Age over 60 (B)</p> Signup and view all the answers

What is the primary focus of medical management for a patient with Ménière's Disease?

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

What type of fluid accumulation is associated with the pathology of Ménière's Disease?

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

What common symptom might worsen with sudden movements in patients with Ménière’s Disease?

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

Which of the following strategies is NOT typically included in patient teaching for those with Ménière's Disease?

<p>Drink plenty of caffeinated beverages (C)</p> Signup and view all the answers

Which medication class is commonly used for symptomatic relief in Ménière's Disease?

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

Flashcards

Osteoporosis

A chronic condition characterized by bone tissue deterioration and reduced density, increasing the risk of fractures.

Bone Resorption

The process where osteoclasts break down old bone tissue.

Bone Mineral Density (BMD)

A measurement of the amount of calcium and other minerals in a bone.

DEXA Scan

A specialized x-ray test to measure bone density.

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FRAX

A tool used to estimate the risk of future fractures based on factors like age, sex, and medical history.

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Osteoarthritis

A degenerative joint disease that causes cartilage breakdown, leading to pain, stiffness, and decreased mobility.

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NSAIDS vs. Tylenol

NSAIDs (Nonsteroidal Anti-inflammatory Drugs) reduce inflammation and pain, while Tylenol (acetaminophen) primarily focuses on pain relief without reducing inflammation.

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Gout

A painful condition caused by too much uric acid in the body, leading to crystal buildup in joints, often in the big toe.

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Paget's Disease

A chronic bone disorder that accelerates bone remodeling, resulting in weak, deformed, and enlarged bones.

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Paget's Disease of the Bone (PDB)

A chronic bone disease that affects the way bone is remodeled, leading to weak, deformed, and enlarged bones.

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Osteoclast Blocking Medications

These medications, such as bisphosphonates, work by inhibiting the activity of osteoclasts, cells responsible for breaking down bone. This helps slow down bone resorption and preserve bone density.

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What is the concern with using Bisphosphonates?

Bisphosphonates can lower calcium levels in the blood (hypocalcemia), which can cause muscle cramping and irregular heart rhythms.

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What is the benefit of sunlight?

Sunlight provides a natural source of Vitamin D, which is crucial for calcium absorption and bone health.

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What are SERMs?

Selective estrogen receptor modulators (SERMs) are medications that act as both estrogen agonists and antagonists. They can promote calcium reabsorption, but also carry risks like blood clots.

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What are some clinical manifestations of Paget's Disease?

Common symptoms include a 'Dowager's Hump' (kyphosis), loss of height, and back pain.

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What are some nursing diagnoses related to Paget's Disease?

Common diagnoses include risk for trauma, impaired physical mobility, and risk for falls.

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What are some nursing interventions for Paget's Disease?

Interventions include fall risk assessment, pain management, nutrition education, exercise programs, and medication administration.

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Paget's Disease of Bone (PDB)

A chronic bone disease characterized by accelerated bone remodeling, resulting in structurally abnormal, enlarged but weak bone.

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PDB: Etiology

The exact cause is unknown, but genetics, age, and possible environmental triggers like measles are implicated.

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PDB: Prevalence

Affects about 1-2% of white males over 55, particularly those of European, Dutch, or British descent.

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PDB: Clinical Manifestations

Common symptoms include pain, bone deformities, and fractures, with severe cases potentially leading to heart, neurological, or sensory issues.

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PDB: Diagnosis

Diagnosis involves a physical exam, radiographic imaging, and lab tests showing elevated serum alkaline phosphatase levels.

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PDB: Treatment Goals

Management focuses on managing pain, improving function, and preventing complications.

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PDB: Medical Management

Treatment includes analgesics like aspirin and stronger pain relievers, bisphosphonates (like zoledronic acid) as the preferred medication, and occasionally calcitonin.

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PDB: Surgical Management

Surgical interventions may include joint replacements or spinal decompression to relieve pressure on nerves.

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PDB: Nursing Assessment

Assess for generalized pain, bone deformities, neurological changes, and signs of fracture.

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PDB: Nursing Interventions

Provide pain management, support exercise, monitor medications, provide education on medication, calcium, and vitamin D intake, and assess fall risk.

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Carpal Tunnel Syndrome

Compression of the median nerve in the wrist caused by swollen or thickened synovium, leading to pain and numbness in the hand.

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Who's at risk for CTS?

People with repetitive hand movements, certain medical conditions like diabetes or rheumatoid arthritis, and those with growths in the wrist area are at higher risk.

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Phalen's Test

A diagnostic maneuver where the wrist is flexed for a minute, causing numbness or tingling in the hand if positive, suggesting carpal tunnel syndrome.

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Tinel's Sign

Tapping on the median nerve at the wrist that produces tingling or numbness in the hand, a positive sign for carpal tunnel syndrome.

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Carpal Tunnel Release Surgery

Surgical procedure to relieve pressure on the median nerve by cutting the transverse ligament in the wrist.

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Night Splinting

Wearing a splint at night to keep the wrist in a neutral position and prevent pressure on the median nerve.

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Nursing Interventions for CTS

Assess work/activity history, perform physical exam, administer medications, provide education, collaborate with occupational therapists and monitor for symptom improvement.

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Untreated CTS

Can lead to chronic pain, immobility, and loss of sensory and motor function in the hand.

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Hyperuricemia

Having too much uric acid in the blood.

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What are some risk factors for gout?

Obesity, hypertension, high intake of meat and seafood, certain medications (thiazides, aspirin), consuming large amounts of alcohol (especially beer), and high purine foods.

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What are tophi?

Nodules or deposits of uric acid crystals in joints and soft tissues that occur with chronic gout.

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How is gout usually diagnosed?

Diagnosis is often based on symptoms. The gold standard is synovial fluid aspiration, where uric acid crystals are identified.

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What's the difference between acute gout and chronic gout?

Acute gout is a sudden onset of pain, redness, and swelling. Chronic gout involves repeated attacks over years, causing tophi and potential joint damage.

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What are some non-pharmacological treatments for gout?

Weight loss, limiting alcohol, avoiding high-purine foods, avoiding high-fructose foods/beverages, and splinting the affected joint.

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What medications are used for acute gout?

NSAIDs (like Indomethacin or Ibuprofen), corticosteroids (like Prednisone), Colchicine.

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What medications are used for chronic gout?

Uric acid-lowering agents (like Allopurinol or Febuxostat). NSAIDs may be added for pain.

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What are potential complications of gout?

Kidney stones, pyelonephritis, kidney injury, kidney disease, progressive disability, joint deformity, skin breakdown leading to infection, and cartilage damage resulting in secondary osteoarthritis.

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What is conjunctivitis?

Inflammation of the conjunctiva, the protective membrane lining the inside of the eyelids. Commonly called "pink eye," it can be caused by infections, allergies, or irritants.

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Viral conjunctivitis

The most common type of conjunctivitis, characterized by clear watery discharge and often resolves on its own.

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Bacterial conjunctivitis

A type of conjunctivitis caused by bacterial infection, characterized by thick, pus-like discharge and often requiring antibiotic treatment.

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Risk factors for conjunctivitis

Poor hygiene, contact lens use, contaminated makeup or eye drops, and epidemic outbreaks can increase the risk of conjunctivitis.

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Medical management of conjunctivitis

Treatment focuses on identifying the cause and administering appropriate medication. Viral conjunctivitis typically resolves on its own, while bacterial conjunctivitis requires antibiotics.

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Nursing interventions for conjunctivitis

Assessments include vital signs, eye appearance, and diagnostic results. Interventions involve providing comfort care, administering medication, teaching about infection prevention, and collaborating with healthcare providers.

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What are cataracts?

Clouding of the natural lens of the eye, which can impair vision.

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Risk factors for cataracts

Age is the most common risk factor for cataracts, with other contributing factors including diabetes, smoking, and prolonged exposure to UV radiation.

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Clinical manifestations of cataracts

Symptoms include blurry vision, double vision, halos around lights, difficulty seeing at night, and faded colors.

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Medical management of cataracts

Treatment typically involves surgical removal of the clouded lens and replacement with an artificial lens implant.

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What is glaucoma?

A group of eye conditions that cause damage to the optic nerve due to increased pressure inside the eye (intraocular pressure, IOP), leading to vision loss, especially in the peripheral field.

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What are the main causes of glaucoma?

Glaucoma arises from either inadequate drainage of aqueous humor from the eye or overproduction of this fluid, both leading to increased IOP.

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What is IOP?

Intraocular pressure (IOP) is the pressure within the eye, measured in millimeters of mercury (mmHg). Normal IOP is considered to be below 21 mmHg.

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Primary open-angle glaucoma

The most common type of glaucoma, where the drainage angle between the iris and cornea is open, but the drainage system is not functioning efficiently, leading to increased IOP.

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Angle-closure glaucoma

A rare but urgent type of glaucoma where the iris blocks the drainage angle, rapidly increasing IOP and potentially leading to permanent vision loss.

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What is a cataract?

A clouding of the eye's natural lens, often caused by aging and factors like UV light exposure, smoking, diabetes, or obesity.

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What are common symptoms of cataracts?

Blurry vision, especially at night, sensitivity to light and glare, halos around lights, faded colors, and progressive painless vision loss.

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What is the most effective treatment for cataracts?

Surgical removal of the clouded lens.

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What are some risk factors for cataracts?

Exposure to UV light, advanced age, family history, race/ethnicity, diabetes, obesity, high blood pressure, smoking, and alcohol use.

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What is a red light reflex?

A normal finding when shining a light into the eye, reflecting off the back of the eye.

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What is a retinal detachment?

A medical emergency where the retina separates from the back of the eye.

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What are some symptoms of retinal detachment?

Floaters in the visual field, flashes of light, and a curtain-like appearance over the field of vision.

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What are some nursing diagnoses related to cataracts?

Disturbed visual sensory perception, risk for injury, anxiety, difficulty seeing at night, blurry vision, and light sensitivity.

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What are some nursing interventions for cataract patients?

Implementing safety measures, administering eye drops, elevating the head of the bed, maintaining an eye patch, administering stool softeners, using prophylactic eye drops, protecting the eye with a shield, and providing pre- and postoperative education.

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What are some important nursing interventions for patients with potential retinal detachment?

Immediately alert the eye care professional, as this condition requires emergency attention.

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What is Angle Closure Glaucoma?

A serious eye condition where the iris blocks the flow of fluid (aqueous humor) from the eye, increasing pressure inside the eye (intraocular pressure or IOP).

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What are the symptoms of Acute Angle-Closure Glaucoma?

Sudden onset of severe eye pain, headache, nausea, blurred vision, seeing halos around lights, and a pupil that doesn't react to light.

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What is Open Angle Glaucoma?

A type of glaucoma where the angle between the iris and cornea is open, but the drainage system of the eye is blocked, causing a slow increase in IOP.

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What is the primary goal of treating glaucoma?

To prevent damage to the optic nerve by lowering IOP to a safe range.

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Prostaglandin Analogs

A common type of eye drop used to treat open-angle glaucoma by increasing the outflow of aqueous humor, reducing IOP.

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What's the effect of increased intraocular pressure?

Increased intraocular pressure can damage the optic nerve, leading to progressive and irreversible peripheral vision loss.

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What is macular degeneration?

A deterioration of the macula, a part of the retina responsible for central vision, leading to irreversible central vision loss.

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What causes macular degeneration?

Impaired blood supply to the macula, resulting in cellular waste accumulation and ischemia (lack of oxygen).

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What is the most common type of macular degeneration?

Dry macular degeneration, characterized by light-sensitive cells breaking down and forming drusen (yellow deposits beneath the retina).

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What is wet macular degeneration?

A more serious and advanced form of MD where blood vessels leak blood and fluid, causing rapid damage to the macula.

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What is VEGF?

Vascular endothelial growth factor (VEGF) is a protein that promotes the growth of new blood vessels, but can lead to leakage and damage in wet macular degeneration.

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What are common symptoms of macular degeneration?

Straight lines appearing distorted or wavy (metamorphopsia), dark or blurry areas in central vision (scotomas), absent or distorted central vision, and diminished color perception.

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How is macular degeneration diagnosed?

A comprehensive eye exam with pupil dilation, tonometry to measure IOP, Amsler grid (for early detection), and fluorescein angiogram (to confirm wet MD).

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What is the primary treatment for dry macular degeneration?

High-dose antioxidants and zinc supplements (vitamin C, vitamin E, beta-carotene, zinc, copper), and specific nutritional recommendations.

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What are some treatment options for wet macular degeneration?

Laser surgery to destroy leaky blood vessels, photodynamic therapy (PDT) with a light-activated medication, and injections into the eye with anti-VEGF therapy.

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What are some nursing interventions for patients with macular degeneration?

Safety precautions (guide them), provider follow-up, education on vision loss, community resource referrals, and 5 Ps (pain, position, potty, personal items, pathway).

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What are the goals of managing macular degeneration?

To preserve existing vision, slow down the progression of symptoms, and maintain quality of life.

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What is Ménière's disease?

A disorder of the inner ear that affects the balance system and hearing, often causing episodes of vertigo, tinnitus, and hearing loss.

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What are the main symptoms of Ménière's disease?

Episodes of vertigo (spinning sensation), tinnitus (ringing in the ears), and hearing loss (usually fluctuating).

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What is the mechanism of Timolol in glaucoma?

Timolol is a beta-blocker that reduces the production of aqueous humor, the fluid in the eye, thus decreasing intraocular pressure (IOP).

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What are 3 surgical treatments for glaucoma?

The three main surgical procedures are:

  1. Laser trabeculoplasty: Uses a laser to open clogged drainage canals in the eye.
  2. Filtering surgery/trabeculectomy: Creates an opening in the sclera to allow aqueous humor to drain.
  3. Drainage implants: Inserts a silicone tube to help drain the aqueous humor.
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What are 5 common nursing diagnoses for patients with glaucoma?

  1. Disturbed visual sensory perception
  2. Anxiety
  3. Impaired home maintenance
  4. Increased intraocular pressure
  5. Visual field defects
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What are typical assessments for patients with glaucoma?

Assessments include:

  1. Physical exam
  2. Diagnostic results, focusing on IOP and visual acuity
  3. Age-related considerations
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Name 3 key nursing actions for glaucoma management.

  1. Administering medications as prescribed
  2. Elevating the head of the bed (HOB) 30-45 degrees
  3. Avoiding bending at the waist
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Why is medication education important for glaucoma patients?

Education is vital to ensure patients understand their condition, medications, and potential side effects, promoting adherence and minimizing complications.

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What are some signs of glaucoma worsening?

Patients should contact their doctor immediately if they experience:

  1. Severe pain
  2. Purulent drainage
  3. Fever
  4. Abnormal swelling
  5. Further vision loss
  6. Bleeding
  7. Sharp pain
  8. Floaters
  9. Nausea/Vomiting
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How is glaucoma similar to cataracts?

Both conditions cause blurry vision and can lead to vision loss. However, glaucoma damages the optic nerve through pressure, while cataracts cloud the lens.

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Parkinson's Disease Interventions

Actions nurses take to help people with Parkinson's Disease. This includes administering medications, ensuring safety, helping with nutrition, and promoting self-care.

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Parkinson's Disease Teaching

Educating people with Parkinson's Disease about medication management, safety measures, and coping strategies.

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Evaluating Parkinson's Care

Assessing the success of care by checking for things like reduced falls and increased ability to live independently.

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Dementia: What is it?

Progressive decline in thinking and memory skills that affects social and daily activities. Most common is Alzheimer's.

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Alzheimer's Epidemiology

Facts and figures about Alzheimer's disease, like the number of people affected and who is more likely to have it.

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Alzheimer's Disease Risk Factor

Having a family history of Alzheimer's makes you more likely to develop the disease.

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Alzheimer's Disease: Forgetfulness

A key sign of Alzheimer's, where memory loss makes it hard to remember recent events and information.

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Alzheimer's: No Diagnostic Test

There isn't a single test to diagnose Alzheimer's. Doctors use medical history, physical exams, and other assessments to make a diagnosis.

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What are the main medical treatments for Alzheimer's Disease?

Treatment focuses on managing symptoms, improving cognitive function, and slowing disease progression. Medications like donepezil, rivastigmine, galantamine, and memantine are used to help manage cognitive decline. Physical and emotional support for both the patient and their caregivers is crucial.

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What are common nursing diagnoses for patients with Alzheimer's Disease?

Common diagnoses include acute confusion, caregiver role strain, and ineffective coping. These reflect the challenges of managing the disease and the impact it has on both the patient and their caregivers.

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What are some nursing assessments for patients with Alzheimer's Disease?

Assessments should focus on physical and emotional well-being. They include weight, intake and output, bowel and bladder function, skin condition, activities of daily living, environment and safety, and coping mechanisms.

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How can nurses help patients with Alzheimer's Disease?

Nursing interventions include encouraging and assisting with feeding, implementing safety measures, promoting routine toileting, providing a structured environment with a clock and calendar, offering routine activities, speaking calmly, providing diversionary activities, and offering emotional support.

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What are nursing interventions for educating families about Alzheimer's Disease?

Nursing interventions focus on empowering families to provide care. This includes teaching families how to provide care for the patient, labeling dangerous substances, informing them about monitoring systems, and providing referral assistance to support them in their caregiving role.

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Parkinson's Disease

A progressive neurological disorder that affects movement, caused by the loss of dopamine-producing brain cells.

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Dopamine's Role

Dopamine is a neurotransmitter crucial for smooth, coordinated movements. Parkinson's disease occurs due to a lack of dopamine in the brain.

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Cardinal Symptoms

The primary symptoms of Parkinson's disease include resting tremors, muscle rigidity, slow movement (bradykinesia), and postural instability.

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Diagnosis of Parkinson's

Parkinson's disease is diagnosed based on the presence of at least two cardinal symptoms, with an asymmetrical presentation (one side of the body is affected more than the other).

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Medication Types

Two main types of medications for Parkinson's disease are anticholinergics and dopamine-receptor agonists.

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Nursing Diagnoses

Common nursing diagnoses for Parkinson's patients include risk for falls, risk for constipation, and powerlessness.

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Assessment Focus

When assessing a Parkinson's patient, prioritize tremors, rigidity, bradykinesia, gag and swallow function, mobility, and bowel/bladder control.

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Interventions for Parkinson's

Nursing interventions involve facilitating safe mobility, preventing falls, addressing constipation, promoting self-care, and enhancing communication.

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Open-angle glaucoma

A type of glaucoma where the drainage angle is open, but the drainage system isn't working properly, causing a slow build-up of pressure in the eye.

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Closed-angle glaucoma

A type of glaucoma where the drainage angle is physically blocked, causing a sudden and significant increase in pressure in the eye, often with severe symptoms.

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What are the symptoms of closed-angle glaucoma?

Closed-angle glaucoma often causes sudden, severe eye pain, headache, nausea, blurred vision, seeing halos around lights, and a pupil that doesn't react to light.

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What is the difference between open and closed angle glaucoma?

Open-angle glaucoma has a slow build-up of pressure, while closed-angle glaucoma causes a sudden and significant pressure increase.

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What are some common treatments for glaucoma?

Glaucoma treatments aim to lower intraocular pressure (IOP) and prevent vision loss. Common treatments include eye drops, laser surgery, and traditional surgery.

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What are the main mechanisms causing Glaucoma?

Glaucoma can be caused by either inadequate drainage of the aqueous humor (the fluid in the eye) or overproduction of this fluid.

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What is Intraocular Pressure (IOP)?

Intraocular pressure (IOP) is the pressure within the eye, measured in millimeters of mercury (mmHg). Normal IOP is below 21 mmHg.

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What causes conjunctivitis?

It can be caused by bacteria, viruses, allergies, or irritants like chemicals.

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Why is conjunctivitis a problem?

It's very contagious, spreads easily, and can cause discomfort.

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What are the symptoms of bacterial conjunctivitis?

Thick, pus-like discharge and feeling like there's sand in your eye.

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How is bacterial conjunctivitis treated?

Antibiotic eye drops or oral antibiotics are usually used.

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What are some risk factors for conjunctivitis?

Poor hygiene, contact lens use, contaminated makeup, and outbreaks.

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What causes cataracts?

Aging is the main cause, but other factors include diabetes, smoking, and UV exposure.

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Ménière's Disease

A disorder of the inner ear that affects balance and hearing, characterized by episodes of vertigo, tinnitus, and fluctuating hearing loss.

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What causes Ménière's Disease?

The exact cause is unknown, but correlations exist with infections, stress, traumatic injury, and allergies.

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Endolymphatic Fluid

The fluid inside the inner ear canals that can become excessive in Ménière's Disease, leading to obstruction and distention of the labyrinth.

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Ménière's Disease Symptoms

Vertigo, tinnitus, fluctuating hearing loss, nausea, vomiting, sweating, sensitivity to movement, diarrhea, headache, abdominal pain, and uncontrollable eye movements.

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Ménière's Disease Treatment

Medications for symptomatic relief, low sodium diet, avoidance of triggers, acupuncture, regular exercise, and limiting caffeine and alcohol.

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Ménière's Disease Surgery

Decompression of the endolymphatic sac, vestibular nerve transection, labyrinthectomy, or surgical gentamicin injection for severe cases.

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Ménière's Disease Nursing Diagnoses

Disturbed sensory perception, risk for injury/falls, and ineffective coping.

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Nursing Interventions for Ménière's

Monitoring vital signs, assessing for Romberg's sign, caloric testing, MRI/CT scans, administering medications, limiting sodium, positioning the patient, safety measures, collaborating with neurology, and acupuncture.

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Patient Education for Ménière's

Teaching about the disease process, pre- and post-testing instructions, medication, safety information, and follow-up care.

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Evaluating Ménière's Care

Monitoring for control of clinical manifestations, medication effectiveness, patient comprehension of education, and follow-up adherence.

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How are cataracts treated?

Surgical removal of the clouded lens and replacement with an artificial lens implant.

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What causes increased IOP in glaucoma?

Inadequate drainage of aqueous humor from the eye or overproduction of this fluid.

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What are the two main types of macular degeneration?

Dry macular degeneration (most common) and wet macular degeneration (less common, but more serious).

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How is glaucoma diagnosed?

A comprehensive eye exam with pupil dilation, tonometry to measure IOP, and Amsler grid (for early detection).

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Osteoarthritis: What is it?

A slow, progressive condition that affects the joints. It's not caused by inflammation, but by the breakdown of cartilage, which leads to bone rubbing on bone and causes pain, stiffness, and decreased mobility.

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Osteoarthritis: Pathophysiology

The breakdown of cartilage in the joints leads to exposed bone, causing pain and inflammation. The synovial membrane lining the joint thickens, and the joint surface becomes uneven, which restricts movement. Muscle atrophy also occurs.

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Risk Factors for Osteoarthritis

Common risk factors include age (over 40), genetics, overuse or repetitive stress, obesity, past joint injuries, and certain medical conditions like diabetes.

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Osteoarthritis: Nursing Interventions

Nurses play a crucial role in managing osteoarthritis by educating patients about pain management, promoting joint protection, and encouraging physical therapy to maintain mobility.

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Osteoarthritis: Medical Management

Treatment options include: Pain relief using NSAIDs, acetaminophen, or corticosteroids. Physical therapy for strengthening, stretching, and mobility. Weight management to reduce joint stress. Joint replacement surgery in severe cases.

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Osteoarthritis: Major Risk Factor?

Obesity is a significant risk factor for developing osteoarthritis, especially in weight-bearing joints like knees and hips.

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Osteoarthritis: Hallmark Symptom

Progressive pain that worsens with activity and improves with rest is a characteristic symptom of osteoarthritis.

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Osteoarthritis: What's Crepitus?

Crepitus is a crackling or popping sound that may occur in joints affected by osteoarthritis, caused by rough cartilage surfaces rubbing together.

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Osteoarthritis: Non-Pharmacological Treatment

Non-medication strategies like weight loss, heat/cold therapy, regular exercise, and assistive devices play a crucial role.

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What are the common treatments for acute Gout?

Nonsteroidal anti-inflammatory drugs (NSAIDs) like Indomethacin or Ibuprofen, corticosteroids like Prednisone, and Colchicine.

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What are the common treatments for chronic Gout?

Uric acid-lowering agents like Allopurinol or Febuxostat, and NSAIDs may be added for pain.

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What are some potential complications of Gout?

Kidney stones, kidney injury, joint damage, and skin breakdown leading to infection.

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Paget's Disease of Bone

A chronic bone disorder that accelerates abnormal bone remodeling, leading to weakened and deformed bones.

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What is Osteoporosis?

A chronic condition that weakens bones, making fractures more likely. It's caused by bone breakdown (resorption) exceeding bone building (rebuilding)

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Bone Metabolism: Resorption vs. Building

Osteoclasts break down old bone (resorption) while osteoblasts build new bone. In osteoporosis, resorption dominates.

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Primary Risk Factors for Osteoporosis

Factors that directly contribute to bone loss, including age, sex, genetics, ethnicity, and body frame.

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Secondary Risk Factors for Osteoporosis

These factors don't directly cause bone loss but increase your risk, often from health conditions or medications.

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Osteoporosis Diagnosis

Usually diagnosed with a DEXA scan, which measures bone density. Other tests include FRAX (risk assessment) and lab tests to rule out secondary causes.

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PDB: What is the cause?

The exact cause is unknown, but genetics, age, and possible environmental triggers like measles are implicated.

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PDB: Who is affected?

Affects about 1-2% of white males over 55, particularly those of European, Dutch, or British descent.

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PDB: What are the signs?

Common symptoms include pain, bone deformities, and fractures, with severe cases potentially leading to heart, neurological, or sensory issues.

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PDB: How is it diagnosed?

Diagnosis involves a physical exam, radiographic imaging, and lab tests showing elevated serum alkaline phosphatase levels.

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PDB: What is the goal of treatment?

Management focuses on managing pain, improving function, and preventing complications.

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PDB: What are common medications?

Treatment includes analgesics like aspirin and stronger pain relievers, bisphosphonates (like zoledronic acid) as the preferred medication, and occasionally calcitonin.

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PDB: What happens if it's not treated?

Untreated Paget's can lead to fractures, bone deformities, hearing loss, and even heart problems.

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PDB: What are some nursing interventions?

Provide pain management, support exercise, monitor medications, provide education on medication, calcium, and vitamin D intake, and assess fall risk.

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PDB: What happens if it's advanced?

Advanced Paget's can affect vital organs, causing serious complications like heart failure, neurological problems, and sensory loss.

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Dry Macular Degeneration

A condition where the macula (central part of the retina) deteriorates due to impaired blood supply, leading to gradual central vision loss. It is often treated with nutritional supplements.

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Wet Macular Degeneration

A more serious form of macular degeneration where new blood vessels grow beneath the retina and leak blood and fluid, causing rapid central vision loss. Treatment includes laser therapy, PDT, or anti-VEGF therapy.

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What are the main differences between Dry and Wet Macular Degeneration?

Dry Macular Degeneration involves a slow deterioration of the macula due to impaired blood supply, leading to gradual vision loss. Wet Macular Degeneration is more serious, involving new blood vessels leaking blood and fluid, causing rapid vision loss. Dry MD is often managed with supplements, while Wet MD requires active treatment like laser therapy or injections.

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How is Wet Macular Degeneration treated?

Treatments for Wet Macular Degeneration aim to stop the leaky blood vessels and prevent further damage to the macula. Common treatments include laser surgery, photodynamic therapy (PDT) with a light-activated medication, and anti-VEGF injections into the eye.

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What are the two main types of glaucoma?

  1. Open-angle glaucoma: The drainage angle is open, but the system isn't working efficiently. 2. Angle-closure glaucoma: The iris blocks the drainage angle, causing a rapid increase in IOP.
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What are the main risks for developing glaucoma?

Family history, age over 60, Black or Mexican ancestry, diabetes, hypothyroidism, myopia (nearsightedness), prolonged corticosteroid use.

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What are the main goals of glaucoma treatment?

To prevent damage to the optic nerve by lowering IOP to a safe range, usually below 21 mm Hg.

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Conjunctivitis

Inflammation or infection of the conjunctiva, the membrane lining the inside of the eyelids. Commonly called "pink eye", it can be caused by bacteria, viruses, allergies, or irritants.

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Cataracts

Clouding of the natural lens of the eye, often caused by aging and factors like UV light exposure, smoking, diabetes, or obesity.

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Cataracts: What are they?

A clouding of the eye's natural lens, often caused by aging and factors like UV light exposure, smoking, diabetes, or obesity.

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Cataracts: Symptoms

Blurry vision, especially at night, sensitivity to light and glare, halos around lights, faded colors, and progressive painless vision loss.

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Cataract Treatment

Surgical removal of the clouded lens and replacement with an artificial lens implant.

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Glaucoma: What is it?

A group of eye conditions that damage the optic nerve due to increased pressure inside the eye (intraocular pressure, IOP), leading to vision loss, especially in the peripheral field.

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Glaucoma: Types

Two main types: Open-angle (slow progression, open drainage angle, but inefficient drainage) and Angle-closure (sudden onset, iris blocks drainage angle, rapid increase in IOP).

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Glaucoma: Goal of Treatment

To prevent damage to the optic nerve by lowering IOP to a safe range.

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Retinal Detachment: What is it?

A medical emergency where the retina separates from the back of the eye.

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Retinal Detachment: Symptoms

Floaters in the visual field, flashes of light, and a curtain-like appearance over the field of vision.

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Retinal Detachment: Action

Seek immediate attention from an eye care professional, as this is a medical emergency.

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Red Light Reflex: What is it?

A normal finding when shining a light into the eye, reflecting off the back of the eye.

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Glaucoma

A group of eye diseases that damage the optic nerve due to high pressure inside the eye. This can lead to vision loss, especially in the peripheral field.

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Intraocular Pressure (IOP)

The pressure inside the eye, measured in millimeters of mercury (mmHg). Normal IOP is below 21 mmHg.

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Macular Degeneration (MD)

A deterioration of the macula, part of the retina that helps with central vision. Leads to irreversible central vision loss.

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Vertigo

A sensation of spinning or whirling, often associated with Ménière's Disease.

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Tinnitus

A ringing or buzzing sound in the ears, a common symptom of Ménière's Disease.

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Excess endolymphatic fluid

A build-up of fluid within the inner ear canals, believed to be a cause of Ménière's Disease.

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Ménière's Disease Risk Factors

Factors that increase the likelihood of developing Ménière's Disease, such as head injuries, ear infections, allergies, alcohol abuse, and smoking.

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What are common clinical manifestations of Ménière's Disease?

Episodes of vertigo, tinnitus, hearing loss, nausea, vomiting, sweating, increased symptoms with sudden movements, and possibly headaches, abdominal pain, and uncontrolled eye movements.

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What are the focuses of medical management for Ménière's Disease?

Symptomatic relief using medications like benzodiazepines, antihistamines, anticholinergics, and loop diuretics, along with lifestyle modifications like a low-sodium diet, avoiding sudden movements, bright lights, and alcohol.

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What are the options for surgical management in Ménière's Disease?

Indicated for frequent and severe attacks, methods include endolymphatic sac decompression, vestibular nerve transection, labyrinthectomy, and gentamicin injection.

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What are key nursing assessments for patients with Ménière's Disease?

Vital signs, Romberg's test (balance test), caloric test (inner ear function test), and imaging studies like MRI or CT.

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What are important nursing interventions when caring for patients with Ménière's Disease?

Administering medications, limiting sodium intake, positioning the patient appropriately, implementing safety measures, collaborating with neurology, using acupuncture, and providing patient education.

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What is Primary open-angle glaucoma?

The most common type of glaucoma, where the drainage angle between the iris and cornea is open, but the drainage system is not functioning efficiently, leading to increased IOP.

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Study Notes

Coordinating Care for Patients With Musculoskeletal Disorders

  • Learning Objectives:
    • Recognize assessment findings for neuromusculoskeletal illnesses.
    • Employ appropriate nursing interventions for simple or stable neuromusculoskeletal illnesses.
    • Evaluate the effectiveness of nursing interventions for simple or stable neuromusculoskeletal illnesses.
    • Identify individual risk factors for neuromusculoskeletal illnesses and health promotion strategies to decrease incidence.
    • Collaboratively manage the care of patients experiencing neuromusculoskeletal alterations.
    • Identify appropriate health education for patients, families, and communities experiencing neuromusculoskeletal alterations.

Osteoarthritis

  • Definition:

    • A slowly progressive, non-inflammatory disorder of the synovial joints.
    • Affects the entire joint due to biological, chemical, and viscoelastic changes.
    • Characterized by progressive deterioration of articular cartilage, exceeding cartilage production.
    • Also known as degenerative joint disease.
  • Pathophysiology:

    • Cartilage loss
    • Unprotected bone
    • Deterioration of joint function
    • Synovial membrane thickens
    • Joint surface becomes uneven, restricting movement
    • Muscle atrophy
    • Bone spurs
    • Joint space narrowing
    • Subchondral bone cysts
    • Thickening of the joint capsule and synovium
  • Epidemiology:

    • Most common form of arthritis in the US.
    • Affects 27 million people in the US.
    • Leading cause of chronic disability in older adults.
    • Global prevalence increasing.
    • Medical costs are between 1% and 2.5% of GDP in high-income countries.
    • Associated with postmenopausal estrogen loss.
  • Risk Factors:

    • Age (over 55 most affected)
    • Female sex
    • Genetics
    • Family history
    • Other bone/joint disorders
    • Obesity
    • Occupation
    • Metabolic disorders
  • Common Affected Joints:

    • Knees
    • Hips
    • Feet
    • Lumbar spine
    • Cervical spine
    • Proximal interphalangeal joints
    • Distal interphalangeal joints of the hands
    • Other joints
  • Clinical Manifestations:

    • Progressive pain over time, increased by activity, relieved with rest.
    • Decreased range of motion.
    • Tenderness to touch.
    • Swelling
    • Crepitus (a crackling sound).
    • Radiographic findings may show decreased joint space, possible fractures, and bone spurs and possibly also Heberden's and Bouchard's nodes.
    • Painful ROM
    • Instability
  • Medical Management (Diagnosis):

    • History taking
    • Laboratory testing (ESR, CRP) - usually normal in OA.
    • Radiographs (X-rays) to check for decreased joint space, possible fractures, and bone spurs.
    • CT and MRI (less frequently used).
    • Possibly joint aspiration
  • Medical Management (Treatment):

    • Nonpharmacological: Weight loss, heat/cold therapy, aerobic exercise, physical/occupational therapy, assistive devices, therapeutic footwear, joint protection (braces/splints), energy conservation.
    • Pharmacological: Acetaminophen (hepatotoxic max 4g daily), NSAIDs (nephrotoxic), corticosteroids (or hyaluronan injections), opioids.
    • Importance of short-term use of medications.
    • Managing lifestyle to reduce risk.
    • Possible need for CAM remedies.
  • Surgical Management:

    • Arthroscopic irrigation and/or debridement
    • Arthroscopic synovectomy
    • Surgical fusion
    • Total joint replacement (total arthroplasty)
    • Other surgical options for specific injuries or conditions
  • Complications:

    • Increased risk of serious cardiovascular thrombotic events, myocardial infarction, stroke, renal failure in patients with existing risks.
    • Gastrointestinal adverse events, including bleeding, ulceration, and perforation of the stomach.
    • Specific complications related to treatment may also occur.
    • Potential for joint infections.

Gout

(Existing information retained.)

Osteoporosis

(Existing information retained.)

Paget's Disease of the Bone (PDB)

(Existing information retained.)

Foot Disorders

(Existing information retained.)

Carpal Tunnel Syndrome (CTS)

(Existing information retained.)

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Test your knowledge on osteoporosis, including its risk factors, diagnostic tools, and management strategies. This quiz covers essential information related to bone health and common conditions affecting bone density. Learn about the role of hormones, medications, and the importance of DEXA scans in assessing osteoporosis.

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