Shared Flashcard Set

Details

Adult Health Test 2
Fractures, Osteoporosis, Diabetes, Hypo/Hyperthyroidism
45
Nursing
Undergraduate 3
05/05/2012

Additional Nursing Flashcards

 


 

Cards

Term
Fracture
Definition
any break in the continuity of the bone
closed: skin remains intact
open (compound): skin integrity is interrupted
Term
Classification of Fractures
Definition
Oblique: at an angle to the bone
Spiral: curves around the bone
Avulsed: pulls bone and tissue away from point of attachement
compressed: bone is crushed
impacted: broken bone ends are forced into each other
depressed: broken bone is forced inward
Term
Fracture Healing
Definition
Inflammatory phase
Reparative phase
Remodeling phase
Term
Inflammatory phase of Fracture Healing
Definition
bleeding and inflammation that develop at the site of the fracture
-lymphocites and monocytes wall of the area of injury
Term
Reparative phase of Fracture Healing
Definition
Calcium is deposited and a callus forms
Osteoblasts promote the formation of new bone
Term
Remodeling Phase of Fracture Healing
Definition
Excessive calcium is removed and new bone is laid down along the fracture line
Term
Risks associated with Falls/Fractures
Definition
Lower extremity weakness
Hx of falls
Gait problems
Use of Assistive device
Visual Impairment
taking 4+ meds or and anticonvulsant/benzodiazapine
Dementia/Cognitive impairment
Osteoporosis
Fear of Falling
Term
Common Hip fracture sites?
Definition
femoral neck fracture--intracapsular (most common)
Intertrochanteric Fracture--extracapsular
Term
Symptoms of Extracapsular Hip Fracture
Definition
severe pain in the groin and hip-increases with movement, muscle spasm
Affected hip may be externally rotated and shortened
Term
Symptoms of Intracapsular Hip Fracture
Definition
Moderate discomfort
may have movement
May or may not be able to bear weight
May not be shortened or rotated
Term
Hip Replacement Postop Precautions
Definition
-most not allow internal rotation: use abduction pillow between legs
-Do not allow hip to flex >90 degrees
-Do not cross legs
-Do not put on own socks/shoes for up to 8 weeks
Term
Complications of Fractures
Definition
Fat Embolism Syndrome: confusion, resp. distress, petichiae rash on the chest
Compartment Syndrome
Infection
Term
Compartment Syndrome
Definition
large amounts of pressure in a limited space causes vessels to be constricted-affects BVs and neurons
r/t trauma, infiltration of IV, burns, tight casts
TX fasciotomy-open skin to relieve pressure
Term
5 P's of Compartment Syndrome
Definition
Pain (early)
Paresthesia (early)
Pallor (late)
Pulselessness (late)
Paralysis (irreversible damage)
Term
Osteoporosis
Definition
metabolic disease:
osteoclasts break down bone faster than osteoblasts can deposit more
--porous bones
Term
Risk Factors R/t Osteoporosis
Definition
W>M
Aging
small thin body type
sedentary lifestyle
excessive alcohol
smoking
low calcium
medications: aluminum containing antacids, anticonvulsants, PPIs, heparin, corticosteriods
Term
Conditions Associated with Osteoporosis
Definition
Endocrine (DM)
Renal failure
Rheumatoid arthritis
Advanced alcoholism
Liver cirrhosis
Chronic eating disorder
Term
Symptoms of Osteoporosis
Definition
"silent disease"
Loss of height
dorsal kyphosis and cervical lordosis (curving of the spine--hunch back/Dowager's hump)
fractures/pain associated with fractures
Term
Prevention of Osteoporosis
Definition
begin as children!
weight bearing and resistance exercise
Avoid Alcohol, caffeine, tobacco
increase calcium and vitamin D in youth
Bone density scans
Term
Pharmacological TX of Osteoporosis
Definition
Antiresorptive Therapies-inhibit bone resorption
-Estrogen replacement therapy
2. Biphosphonates-potent inhibitors of bone resorption and increase bone density in vertebrae and hip
-Fosamax
-Actonel
-Prolia
Selective Estrogen Replacement Modulators: Evista, Tamofen
Calcitonin: hormone used with calcium supplement
Anabolic therapy: stimulates bone growth
Term
Traction
Definition
Application of pulling force to an injured or diseased part of the body
-reduce, realign and promote healing of fracture bone
-decreases muscle spasm and pain
-immobilization
-corrects/prevents deformity
-rests joint
Term
Russel's Traction
Definition
tx: hip fracture or femoral fracture
pulley system doubles applied weight
--examine pts. position
Term
Skeletal Traction
Definition
Pulling force applied directly through pins inserted into the bone
-allows more weight to be applied
-risk for infection
Term
Glycemic Goals for Diabetics
Definition
Before meals: 90-130
After meals: <180
A1C: <7%
Term
Diabetic Ketoacidosis (DKA)
Definition
Type 1 DM--insulin deficiency leads to
acidosis and ketosis
hyperglycemia
dehydration
electrolyte imbalance
Term
Causes of DKA
Definition
increased caloric intake
inadequate insulin dosage
physical/emotional stress
surgery, infection, illness
undiagnosed type 1 diabetes
Term
Symptoms of DKA
Definition
BG >300
Dehydration:
polyuria initially
dry skin/mucous membranes
sunken eyes
tachycardia
Hypotension
Thirst
Hypovolemic shock
electrolyte imbalance
renal failure
coma, death
Ketosis: ketones in blood and urein
breath has sweet, fruity odor
Metabolic Acidosis: N/V, restlessness, confusion, lethargy
Kussmauls Respirations
Term
Treatment of DKA
Definition
Insulin
Fluids:
first .9%NS
second: 45%NS
third: Dextrose
Potassium Replacement: prevent cardiac dysrhythmias
Term
Hyperosmolar Hyperglycemic State (HHS)
Definition
type 2 DM (non insulin dependent)
severe hyperglycemia
elevated plasma osmolarity
osmotic diuresis
severe fluid depletion/dehydration
Term
Patho of HHS
Definition
hyperglycemia causes fluid to move from intracellular to extracellular spaces to dilute blood
cells become dehydrated leading to neurologic abnormalities and Altered LOC
Term
Causes of HHS
Definition
Infection--most common
Acute illness- burns, stroke, MI, GI bleed, UTI, pancreatitis
Chronic Illness- renal or cardiac disease, hx of stroke
Therapeutic agents: diuretics, glucocorticoids
Therapeutic procedures: dialysis, surgery
Term
Symptoms of HHS
Definition
extreme hyperglycemia >600
increased plasma osmolarity
dry, parched mouth, extreme thirst, altered LOC, warm dry skin with out sweating
Sever dehydration- leading to neuro issues like seizure, hyperthermiea, positive Babinski's somnolence, coma, hypotension and shock
No Acidosis or Ketones
Term
TX of HHS
Definition
Fluid and electrolyte replacement
0.9NS then 0.45NS then Dextrose
--need more fluids than DKA
-insulin is not administered until fluid replacement has begun--first bolus then continuous IV
Term
Sick Day management for DM pts.
Definition
Continue Insulin/antidiabetic meds as prescribed
more frequent glucose testing, report >300
encourage fluids and food, report N/V/D
Term
Hyperthyroidism
Definition
excessive thyroid hormone (T3 and T4) not enough TSH
Term
Grave's Disease
Definition
Autoimmune disease- antibodies attach to TSH receptors on the thyroid gland which stimulate excess release of T3 and T4
Term
Symptoms of Hyperthyroidism
Definition
Heat intolerance
Excessive sweating, warm, most skin
Increased appetite with weight loss
thin sparse hair
fine hand tremors
hyperactivity: tachycardia
shortened attention span
diarrhea
Exophathalmos: bug eyes
Dermopathy (like an orange peel)
Goiter
Term
Diagnosis of Hyperthyroidism
Definition
H&P
Thyroid antibodies (TA)
T3 uptake test
Thyroid suppression test
radioactive iodine test
Term
TX of Hyperthyroidism
Definition
Propylthioruil (PTU)
Methimazole (tapazole)
Radioactive Iodine
Thyroidectomy
Term
Thyroid Storm/Crisis
Definition
Tachycardia, increased systolic BP, N/V/D, abd. pain, restlessness, delirium, seizures, confusion, hyperthermia, psychosis, coma, fever
Term
Hypothyroidism
Definition
Too little T3 and T4, too much TSH
Term
Myxedema
Definition
-occurs often long standing untreated hypothyroidism
puffiness
periorbital edema
masklike look
-can lead to severe metabolic disorders, hypothermia, cardiovascular collapse, impaired cognition, coma
Term
Diagnosis of Hypothyroidism
Definition
H&P
Serum blood levels of T3, T4 and TSH
Thyroid Radioactive uptake
Thyroid antibodies
Term
TX of Hypothyroidism
Definition
lifelong medication
-synthroid
Term
Symptoms of Hypothyroidism
Definition
dry brittle hair, puffy face, goiter, slow HR, cold intolerance, dry skin, fatigue, heavy menstrual period, weight gain, constipation
Supporting users have an ad free experience!