SI Review Session for Week 4 Material - NURS 220

JEOPARDY!
Complications of
Fractures
Beyond expected
healing period
(3-6 months
$200 after
fracture): pain &
tenderness
increase

Disorders r/t
Calcium
Bone
demineralization,
osteoclast
$200
activity exceeds
osteoblast
activity

Osteoporosis Tx

Gout

Misc.

Most common
calcium
salt
$200

The body part

that is most
commonly
$200
affected

A term that
describes a drug
that causes
$200 birth
defects

Build up of
pressurerestricted
by
$400
unyielding
fasciae

Adult form of the

Vitamin D
Can receive
deficiency
through
sun and
$400
$400
disorder
fortified milk

The phase in
which there are
no clinical
$400 signs
except for
increased serum
urate levels

A type of drug
that binds to a
receptor
and
$400
causes a response
that is the same,
or mimics, the
normal response

Severe pyogenic
infection of bone
and local tissue

Resorbed bone is
replaced with
abnormal bone

$600

$600

The phase in
which weight
bearing joints are
now affected,
causing
the area
$600
to become warm,
red, and tender

Fusion of
inflamed
vertebrae,
arthritis of
sacroiliac
$600jointsinvolving the
axial skeleton
and sometimes
peripheral joints

The phase that

consists of
intervals between
acute attacks
$800 in
which there are
no symptoms

The hormone that

moves calcium
into the blood
when serum
$800
calcium levels
are too low.

The phase that

involves
advanced
deforming
$1000gout
in which tophi
develop

Measures the rate

in which half of
the original
amount
of drug is
$1000
removed from
the body

Thrombosis
forms in distal
extremity
$800

Fat particles
released from
bone marrow
(pelvis,
long
$1000
bones) into blood
stream and lodge
in lung
vasculature

Vitamin D
deficiency in
children causing
defective
$800bone
growth
Slowly
progressive
disorder
involving
$1000
increased bone
resorption

Must take on an
empty stomach
because OJ or
coffee$600
decreases
absorption by
60%

This form of Tx
is a SERM
$800

PTH, the only

drug that
increases
bone
$1000
formation

Other Complications of Fractures

Malunion
Nonunion
Osteonecrosis
Compartment Syndrome
Tissue pressure ______ Intravascular pressure
5 P's:
1.
2.
3.
4.
5.

P
P
P
P
P

Tx:
Osteomyelitis
How does the organism (e.g., bacteria) reach the bone?
Tx:
Thrombosus vs. Embolus

Pulmonary Embolism (PE)

Risk factors:
S/Sx:
Tx:
Prevention:

Fat Emboli Syndrome

S/Sx:
Diagnostic tests:
Tx:
Prevention:
OA vs. RA GAME!
OA

RA

Ankylosing Spondylitis
S/Sx:
Tx:
Disorders r/t Calcium:
Rickets
Leads to . . .
Paget's Disease
Leads to . . .
Osteoporosis
Leads to . . .

Osteoporosis Tx
Calcium Salts
Calcium ________ = most common
Calcium ________ = best absorbed
Calcium ________ = most common IV form
Over 51 y.o. - need _______ mg daily calcium intake
But can take no more than ______ mg at one time
So take _____ or ______
Calcitonin (Miacalcin)
Drug forms:
Inhibits:
Treat or Prevent?
Biphosponates
Drug names w/ dose frequency:
Inhibit:
Make sure . . .
because adverse effect = _____________
Raloxifene (Evista)
Estrogen effects

________, _________, ___________

Estrogen effects

________, _________

Adverse effects:

Teriparatide
Continuous

bone __________

Intermittent

bone __________

Acute Gouty Arthritis

Primarily affects _____________ joints - feels _______, ________, ________
Length of initial attacks: __ - __ days, later attacks: more or less frequent?
Pathogenesis:
(1Increased levels of serum uric acid within joints

(2) sodium urates/urate

crystals/nitrate are deposited around/within joints

(3) inflammatory response:

__________ of urate crystals

________________

(4) phagocytes _______ & die

Back to (2)

Causes sudden onset of _______ over joints

Tx:
Allopurinol
Colchicine

release

Practice Quiz
1. Which of the following best describes a complication of a fracture in which fracture fragments
do not align properly?
a). Nonunion
b). Delayed union
c). Union
d). Malunion
2. True or False: An embolus is a stationary clot.
3. After fracturing her tibia, your patient has the following signs and symptoms: shortness of
breath, hypoxemia, rapid breathing, fine petechial rash of the neck and torso, and altered mental
status. Which complication of fracture is your patient experiencing?
a). Deep vein thrombosis
b). Pulmonary embolism
c). Compartment syndrome
d). Fat emboli syndrome
4. True or False: Osteoarthritis is an autoimmune, inflammatory, systemic disease.
5. Rheumatoid arthritis causes the following signs and symptoms: (Select all that apply)
a). Ulnar deviation
b). Heberden nodes
c). Swan neck deformities
d). Osteophytes
6. True or False: Raloxifene (Evista) may cause breast or endometrial cancer due to estrogen's
effects on those organs.
7. Which of the following drugs inhibit bone resorption: (Select all that apply)
a). Calcitonin (Miacalcin)
b). Raloxifene (Evista)
c). Teriparatide
d). Biphosphonates
8. Name the 4 Stages of Gout:
1.
2.
3.
4.
9. True or False: Allopurinol (Zyloprim) is used to reduce the inflammatory response to the
deposit of urate crystals in the joint tissue.
10. Name the 5 P's for the signs and symptoms of Compartment Syndrome:

1.
2.
3.
4.
5.