What electrolyte is important in Bone Health and give examples of food that contain it
Calcium
-milk, yogurt, cheese, kale, broccoli, oysters, tofu, cereals, fruit drinks
What are risk factors?
genetics, age, nutrition, physical exercise, lifestyle choices and medications
What types of patients are at risk?
those who are poorly nourished, elderly, or obese. Other patients at risk include those with impaired immune systems, those who are IV drug users, those with chronic illnesses (e.g., diabetes, rheumatoid arthritis, neuropathy, and arterial insufficiency), and those receiving long-term corticosteroid therapy or immunosuppressive agents.
what fracture involves a break across the entire cross-section of the bone and frequently is displaced (removed from its normal position)?
complete fracture
normal HbA1c
<7
Name diagnostic procedures for low back pain
what is xray of spine, bone scan and blood studies, CT, MRI, and EMG
How is Osteoporosis diagnosed?
by dual-energy x-ray absorptiometry (DEXA), which provides information about BMD at the spine and hip
Why are bone infections difficult to treat?
Bone infections are more difficult to eradicate than are soft tissue infections because the infected bone is mostly avascular (without blood vessels) and not accessible to the body’s natural immune response. Also, there is decreased penetration by antibiotics.
what is a priority immediately after a fracture?
-immobilize the body part
-hemodynamic stability
-protect the wound (from infection, cover with sterile dressing if needed)
normal calcium levels
8.6-10.3
How can a patient relieve back pain without pain meds?
- reduce stress on back
-change positions frequently
-diaphragmatic breathing and relaxation
-diverting attention
What are pharmacologic therapies?
-Denosumab
-Calcitonin
-Calcium
-Vitamin D
How to diagnose?
Radioisotope bone scans, particularly the isotope-labeled white blood cell (WBC) scan, and magnetic resonance imaging (MRI) help with early definitive diagnosis. Blood studies reveal leukocytosis (elevated WBCs) and an elevated ESR and C-reactive protein in hematogenous and acute osteomyelitis, but those counts may be normal in chronic contiguous osteomyelitis. Wound and blood culture studies are performed to identify the offending organisms so appropriate antibiotic therapy can be instituted.
thirst, anxiety, tachycardia, weak pulse, hypotension, cool skin, decreased UO, are s/s of what?
hypovolemic shock
TSH
0.5 to 5.0
What is the first line drug treatment for back pain?
Nonprescription analgesics
What is the mechanism of calcitonin?
Calcitonin directly inhibits osteoclasts, thereby reducing bone loss and may increase osteoblast activity; it also helps to regulate calcium via bone, renal, and GI effects. Calcitonin is administered by nasal spray or by subcutaneous or intramuscular injection
Ways to prevent osteomyelitis
-postpone surgery if sick
-prophylactic ABX
-remove drains and catheters ASAP
-aseptic wound care
-control blood sugars in DM
risk factors for fat emboli
(fat globules released when the bone was fractured may occlude the small blood vessels that supply the lungs, brain, kidneys, and other organs)
trauma, crash inquiries, fracture of long or pelvic bones, orthopedic surgery
T4 and T3
t4: 5-12
t3:80-220
What can contribute to low back pain?
obesity, stress, depression, age
What is secondary osteoporosis related to?
associated with many disease states, nutritional deficiencies, and medications. Coexisting medical conditions, such as gastric bypass, malabsorption syndromes, lactose intolerance, malnutrition, alcohol abuse, kidney failure, liver failure, Cushing syndrome, hyperthyroidism, and hyperparathyroidism, contribute to bone loss and the development of osteoporosis. Medications, including corticosteroids, antiseizure medications, heparin, tetracycline, aluminum-containing antacids, and thyroid supplements, affect the body’s use and metabolism of calcium
Medical management osteomyelitis
-surgical debridement
-IV ABX
late signs of compartment syndrome
pallor and loss of pulses (may need a fasciotomy)
fasting blood glucose
70-110