Osteoporosis Anemia

Pathophysiology: A bone disease that occurs when the body loses to much Pathophysiology: a condition when your body doesn’t have enough healthy
bone, makes to little bone or both causing them to become weak and brittle red blood cells. Many different causes of anemia: Iron deficiency anemia,
vitamin deficiency anemia, hemolytic anemia, sickle cell anemia.
Risk Factor: Age, race, sex, lifestyle choices (smoking, alcoholism, sedentary),
diet (low calcium, eating disorders) GI surgery, family history, small body frame Risk Factor: a diet lacking certain vitamins and minerals, intestinal disorders,
menstruation, pregnancy, family history, age, blood diseases, autoimmune
Clinical Manifestation: back pain caused by fractured or collapsed vertebra, disorders.
loss of height over time, stooped posture, bones that break easily
Clinical Manifestation: fatigue, weakness, irregular heartbeat, shortness of
Complications: Bone fractures – spine and hip are the most serious breath, dizziness, chest pain, cold hands and feet, headaches

Nursing Interventions: Calcium, vitamin D and other medications, encourage Complications: severe fatigue, heart problems, death
exercise, good nutrition – protein, green leafy vegetables, low-fat dairy
Nursing Interventions: ensure a good quality diet, administer iron supplements
Diagnostic Testing: X-rays, bone density as per doctor’s orders. Educate the patient on the disorder and what they can
do to help manage their symptoms and disorder (diet, medication, lifestyle)

Diagnostic Testing: Complete Blood Count (CBC):

Patient Information: Don’t smoke, avoid excessive alcohol, prevent falls, take Patient Information: anemia is when there is not enough red blood cells in your
medications body and the lack of blood cells results in lack of oxygen and nutrients to the
cells in your body. Thus ultimately making you feel tired, lack of energy, dizzy
etc..
Macular Degeneration Chronic Kidney Disease (CKD)
Pathophysiology: macular degeneration is a chronic eye disorder that causes Pathophysiology: gradual loss of kidney function for a period of 3 or more
blurred vision or a blind spot in your visual field. months. The kidneys lose the ability to filter waste and excess fluid causing a
There are 2 types: build-up in the body.
Dry – Thinning of the macular optic disk
Wet – abnormal blood vessels that leak fluid into the macular optic disk Risk Factor: diabetes, high blood pressure, heart disease, age, family history.

It does not affect peripheral vision Clinical Manifestation: tiredness, poor appetite, nausea, difficulty breathing,
cramps, swollen feet
Risk Factor: Age, family history, race (Caucasian), smoking, obesity,
cardiovascular disease Complications: gout (improper filtration of uric acid), anemia, heart disease,
fluid build-up
Clinical Manifestation: Visual distortions, reduced central vision, decreased
intensity or brightness of colors, blurry or blind spot in vision, haziness Nursing Interventions: monitor lab values, teach patient about the disease and
help manage and control comorbid diseases (hypertension and diabetes)
Complications: Social isolation and depression
Diagnostic Testing: glomerular filtration testing, ultrasound, CT, kidney biopsy
Nursing Interventions: medication administration, education

Diagnostic Testing: Exam of the back of the eye, fluorescein angiography,

indocyanine green angiography, optical coherence tomography

Patient Information: Routine eye exams, take medication as prescribed, life Patient Information: chronic kidney disease is the gradual loss of the
style changes – smoking, diet, manage other medical conditions, weight functioning of your kidneys. Your kidneys filter excess fluid and waste from your
management body and when your kidneys can no long filter, the build-up of fluid and waste
remains in your body caused problems. Dialysis and kidney transplant could be
required. However it may be managed by diet, exercise and medication if the
disease has not progressed too far.

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Hypertension GERD
Pathophysiology: An elevation in blood pressure commonly defined by a Pathophysiology: Occurs when stomach acid frequently flows back into the
systolic pressure above 140mmhg or a diastolic pressure above 90mmhg tube connecting your mouth to your stomach. This backwash can irritate the
lining of the esophagus.
Risk Factor: The risks of high blood pressure increase as you age, Hypertension
is also hereditary having too much salt in your diet can also cause hypertension Risk Factor: Obesity, bulging of the top of the stomach into the diaphragm,
because your body tends to retain fluid. pregnancy

Clinical Manifestation: Hypertension has reached a certain stage, some people Clinical Manifestation: Burning sensation in your chest usually after eating or at
may have headaches, chest pain, fatigue, shortness of breath or nosebleeds night, chest pain, difficulty swallowing, regurgitation
but it is not common.
Complications: Narrowing of the esophagus, esophageal ulcer, precancerous
Complications: Heart attack or stroke might result to heart failure, metabolic changes (Barrett’s esophagus)
syndrome etc.
Nursing Interventions: Eat slowly and chew foods well. Remain in upright
Nursing Interventions: monitor blood pressure, assess for signs and symptoms position at least 2 hours after meal. Avoid eating 3 hours before bedtime
of high blood pressure (such as, headaches, shortness of breath, fatigue, chest
pain), administer medication as per orders. Diagnostic Testing: Upper endoscopy, pH probe test, Esophageal manometry,
barium swallow
Diagnostic Testing: A specialist will usually use a blood pressure cuff to check
your systolic and diastolic pressure. The normal range is a 120/80mmhg but
you become hypertensive when the cuff reads from a 140mmhg or higher for
systolic and 90mmhg or higher for diastolic.

Patient Information: Patient Information:

Femur Fracture Irritable Bowel Syndrome
Pathophysiology: a complete or incomplete break of one of the femur bone Pathophysiology: Altered gastrointestinal motility, visceral hypersensitivity,
post infectious reactivity, brain-gut interactions, alteration in fecal micro flora,
Risk Factor: Repeated stress on bones, falls, osteoporosis, decreased bone bacterial overgrowth, food sensitivity, carbohydrate malabsorption, and
density intestinal inflammation all have been implicated in the pathogenesis of IBS.

Clinical Manifestation: Pain, bruising, swelling, cold, blue, numb, deformed Risk Factor:IBS occurs more frequently in people under age 50.  Estrogen
therapy before or after menopause also is a risk factor for IBS. Genes may play a
Complications: Severe pain, reduced circulation (blue, cold or numb) role, as may share factors in a family's environment or a combination of genes
and environment. A history of sexual, physical or emotional abuse also might be
Nursing Interventions: Bed rest or limb rest, support joints above and below a risk factor.
facture, assess for edema, review restrictions, pain management review x-rays
and follow up x-rays Clinical Manifestation: Abdominal pain, cramping or bloating that is related to
passing a bowel movement. Changes in appearance of bowel movement.
Diagnostic Testing:. X-rays, CT or MRI
Changes in how often you are having a bowel movement

Complications: Chronic constipation or diarrhea can cause hemorrhoids.

Experiencing the signs and symptoms of IBS can lead to depression or anxiety.
Depression and anxiety also can make IBS worse.

Nursing Interventions: Explore the patient’s daily nutritional intake, and food
habits. Create food and a daily weight chart, refer the patient to a dietitian, IBS
with severe diarrhea, place the patient on NPO and gradual progress to clear
fluids. Pain medication.

Diagnostic Testing: Colonoscopy, X-ray or CT scan, Upper endoscopy, Lactose

intolerance tests, Breath test for bacterial overgrowth, Stool tests

Patient Information: Follow doctors orders about how long to keep airboot in Patient Information: Regular exercise to promote regular bowel
place, elevate, ice, don’t wrap to tightly that it cuts off circulation, follow movements, healthy diet with fiber supplements.
weight baring instructions
Dysphagia Dementia
Pathophysiology: Difficulty swallowing Pathophysiology: Dementia describes a group of symptoms affecting memory,
thinking and social abilities severely enough to interfere with your daily life.
Risk Factor: Brain disturbances (Parkinson’s, MS, ALS), oral or pharynx
dysfunction such as stroke, Loss of sphincter muscle relaxation (achalasia), Risk Factor: Age, family history, down syndrome, diet and exercise, heavy
esophageal narrowing from acid reflux or tumors, GERD, foreign bodies, alcohol use, cardiovascular risk factors, depression, diabetes, smoking, sleep
radiation therapy apnea

Clinical Manifestation: Frequent choking on food, pain when swallowing, Clinical Manifestation: Memory loss, difficulty communicating or finding words,
hesitancy in swallowing for more than a few seconds, sensation of food getting confusion, disorientation, personality changes, depression, anxiety,
stuck, being hoarse, heartburn, weight loss, coughing and gagging when inappropriate behavior.
swallowing
Complications: Poor nutrition, pneumonia, inability to perform self-care tasks,
Complications: Choking, aspiration pneumonia, malnutrition, weight loss, personal safety challenges, death
dehydration
Nursing Interventions: Orient client. Frequently orient client to reality and
Nursing Interventions: Position in high fowlers with head slightly forward, Rest surroundings. Explain simply, use simple explanations and face to face
before mealtime, eliminate environmental stimuli, provide oral care before interaction when speaking with client
feedings – clean and insert dentures before each meal, place suction
equipment at the bedside and suction as needed, consult dysphagia team Diagnostic Testing: No single diagnosis for dementia, cognitive and
(physician, rehabilitation nurse, speech pathologist, dietitian), ensure adequate neuropsychological tests, CT, MRI or PET scans, Vitamin B12 deficiency
LOC, give specific directions (open mouth, chew tuck chin into chest and
swallow)

Diagnostic Testing: Barium swallow, cineradiography, upper endoscopy,

manometry, impedance and pH test
Patient Information: There are exercises that can help swallowing muscles or Patient Information: Will need supportive care
restimulate the nerves that trigger swallowing reflex. Sit in high fowlers and
your head forward to help your body swallow. May need special diet or tube
feeds. Avoid alcohol, tobacco and caffeine

Urinary Incontinence Spinal Stenosis

Pathophysiology: Unintentional loss of urine Pathophysiology : Spinal stenosis (progressive narrowing of the spinal canal) is
part of the aging process, and predicting who will be affected is not possible. No
Risk Factor: Aging of the bladder, involuntary bladder contractions. clear correlation is noted between the symptoms of stenosis and race,
Incontinence often stems from enlargement of the prostate gland, alteration in occupation, sex, or body type
cognitive functioning, weakened supporting pelvic structure.
Risk Factor: Osteoarthritis, Herniated discs, Injuries, Tumors, Paget’s disease,
Clinical Manifestation: Urge incontinence: uncontrolled leakage of Thickened ligaments, Wear and tear damage to the spine in adults over 50.
medium-large amounts of urine usually at night. Stress Incontinence:
Urine leakage due to pressure, such as laughing, coughing, sneezing, Clinical Manifestation: Burning pain going into the buttocks and down into the
lifting. Overflow incontinence: loss is constant and small “dribbling”. legs (sciatica) Numbness, tingling, cramping, or weakness in the legs. Loss of
Functional incontinence: Urine loss due to impairment such as dementia sensation in the feet. A weakness in a foot that causes the foot to slap down
or stroke. when walking
Complications: Skin irritation and pressure ulcers to buttocks and groin
area, unpleasant odor.
Complications: untreated severe spinal stenosis may progress and cause
Nursing Interventions: Create a toileting schedule, ensure patients are permanent numbness, weakness, balance problems, incontinencee, paralysis
changed in a timely manner, ensure dryness and
skin care frequently.
Nursing Interventions: Physical therapy may include exercises to strengthen
your back, stomach, and leg muscles. Learning how to do activities safely, using
Diagnostic Testing: History and physical examination, neurologic
braces to support back, and stretching. Medicines may include nonsteroidal,
evaluation, pelvic exam, urinalysis, urine cultures, post void urine
anti-inflammatory medicines that relieve pain and swelling, and steroid
volume measurement.
injections that reduce swelling.

Diagnostic Testing: x-rays, physical examination, Magnetic resonance imaging

 (MRI), CT or CT myelogram.

Patient Information:
Patient Information:

Hearing Loss Pain

Pathophysiology:. Hearing loss is a condition that occurs when the sound Pathophysiology:
transmission from the outer ear to the brain suffers a disruption. The
disruption can happen at any stage, either before or after the cochlea, and the Risk Factor:
hearing loss is conductive or sensorineural, respectively. If both sites, pre and
post the cochlea, are affected, then the hearing loss is characterized as mixed Clinical Manifestation:

Risk Factor: Aging, Loud noise, Heredity, Occupational noises, Recreational Complications:
noises, Some medications, Some illnesses.
Nursing Interventions:
Clinical Manifestation: Muffling of speech and other sounds, Difficulty
understanding words, especially against background noise or in a crowd, Diagnostic Testing
Trouble hearing consonants, Frequently asking others to speak more slowly,
clearly and loudly, Needing to turn up the volume of the television or radio,
Withdrawal from conversations, Avoidance of some social settings.

Complications: Hearing loss can have a significant effect on your quality of

life. Older adults with hearing loss may report feelings of depression. Because
hearing loss can make conversation difficult, some people experience feelings
of isolation. Hearing loss is also associated with cognitive impairment and
decline. The mechanism of interaction between hearing loss, cognitive
impairment, depression and isolation is being actively studied. Initial research
suggests that treating hearing loss can have a positive effect on cognitive
performance, especially memory.

Nursing Interventions: Nursing interventions should focus on (a) cerumen

management to reduce hearing impairment and allow for the use of hearing
devices; (b) hearing device support so that residents can use hearing aids
and/or other assistive listening devices; and (c) communication strategies so
that conversations with residents can be facilitated .

Diagnostic Testing: Physical exam, whisper test, App-based hearing tests,

Tuning fork tests, Audiometer tests

Patient Information: Use assistive devices, proper ear care. Patient Information: