exam3 N1

Osteoporosis

A condition where bones become fragile and break easily.

Primary osteoporosis

Bone loss that is postmenopausal (estrogen accelerates bone resorption) or age-related.

Secondary osteoporosis

Bone loss resulting from an associated medical condition such as hyperthyroidism, long-term drug therapy, or long-term immobility.

Non-modifiable Risk factors for osteoporosis

Female, older age, postmenopausal status, family hx of osteoporosis or hip fracture, small body frame or low body weight, and being white or Asian.

Modifiable Risk factors for osteoporosis

Low calcium/vitamin D intake, sedentary lifestyle, smoking/excessive alcohol use, and long-term use of corticosteroids or other medications.

Osteoporosis assessment findings

A silent and asymptomatic disease until a fracture occurs; findings include gradual height loss of $2-3$ inches, Kyphosis, back pain, and fragility fractures at the wrist, hips, or spine.

Disuse Syndrome

Signs and symptoms that result from inactivity.

Mobility

The state of quality of being mobile or moveable.

Immobility

The inability to move about freely.

Impaired physical mobility

Limitation in independent, purposeful physical movement of the body or of one or more extremities.

Osteoarthritis (OA)

The most common age-related joint disease characterized by degeneration of synovial joints, causing chronic pain and disability.

Rheumatoid arthritis (RA)

A chronic, systemic autoimmune inflammatory disease involving joint swelling, tenderness, and destruction; it can also affect the lungs, heart, and kidney.

Left-sided hemiplegia

Destruction of the right motor strip which can result from a right-sided cerebral hemorrhage.

Complete spinal cord transection

Loss of motor control below the level of injury.

Pathological fractures

Fractures that occur from bone weakened by disease, such as osteoporosis.

Maximum assist (#1)

Mobility level requiring a mechanical lift or slide board and staff assistance; patient may reach across midline to shake hands or sit at the edge of the bed.

Moderate assist (#2)

Mobility level where the patient can extend legs, flex ankles, and point toes while seated; requires sit-to-stand ambulation aids and staff.

Minimal assist (#3)

Mobility level where the patient rises from a seated position using assistive devices and stands for $75$ secs; requires a gait belt and $1-2$ staff.

No assist (#4)

Mobility level where the patient marches in place and steps forward and backwards; requires $0-1$ staff.

Normalized deviation

Unacceptable norms forming over time, such as not using full PPE when required.

Right to informed consent

Composed of the right to autonomy and the right to be informed of potential harm and risks of a procedure.

Competence

Someone having sufficient capacity and ability to make reasoned decisions.

Capacity

Evaluation or assessment of a person's ability to understand, appreciate, and manipulate information to form a radical decision.

Tort

Someone carrying out an act or failing to carry out an act that results in injury or harm to the patient.

Near miss event

An error of commission or omission that could have harmed the patient, but serious harm did not occur because the error was caught.

Adverse Event

An event that results in unintended harm to the patient by an act of commission or omission rather than by the underlying disease or condition.

Sentinel event

An unexpected occurrence involving death or serious physical or psychological injury that requires immediate investigation and response.

Patient Self-Determination Act (PSDA)

Gives the patient the right to refuse treatment and informs them of their right to make decisions regarding their care.

Advance directives

Written documents outlining the wishes of the patient if they cannot make decisions themselves.

Voluntary admissions

When a patient comes to a facility for services and signs a consent form; they may stay for as long as necessary.

Involuntary admissions

When someone is deemed harmful to self or others; can be implemented in emergency situations.

Assault

Threatening to touch someone without consent.

Battery

Touching someone without their consent.

Libel

Written defamation of character using false statements.

False imprisonment

Restraining, detaining, or restricting a person's freedom of movement, such as restraining someone without a doctor's orders.

Cane usage technique

Hold the cane opposite of the weaker side and move the cane forward with the weaker leg.

Walker usage technique

Push the walker a few inches forward, step forward with the weaker leg first, then follow with the stronger leg.

Proper body mechanics

Maintain upright posture with shoulders back, contract abdominal muscles, keep lower back neutral, squat rather than bending at the waist, and pivot instead of twisting the torso.

Pathological influences on mobility

Muscle abnormalities and CNS damage

Premorbid phase

The initial phase of schizophrenia characterized by shy and withdrawn behavior, poor peer relationships, antisocial behavior, and poor performance in school.

Prodromal phase

A phase lasting a few weeks to a few years where social withdrawal and role functioning impairment become more apparent, along with depressed mood and poor concentration.

Acute schizophrenic episode

The third phase of schizophrenia where psychotic symptoms are present, including delusions, hallucinations, and impairment in work, social relations, and self-care.

Residual phase

The final phase of schizophrenia, similar to the prodromal phase, where flat affect and impairment in role functioning are prominent.

Psychosis

A severe mental condition involving disorganization of the personality and disturbances in thought processes, perception, and affect, resulting in severe deterioration of social and occupational functioning.

Negative symptoms

Symptoms that fall below baseline, such as lack of emotional expression, lack of motivation, lack of communication, anhedonia, and withdrawal from relationships.

Waxy flexibility

The passive yielding of all movable parts of the body to any effort made at placing them in certain positions.

Anergia

A deficiency of energy.

Hallucinations

False sensory perceptions not associated with real external stimuli; can be auditory, visual, tactile, gustatory, or olfactory.

Delusions

Fixed, false beliefs, such as paranoia, grandeur, or jealousy (e.g., believing one is being plotted against).

Positive symptoms

Symptoms that are above baseline, including delusions, hallucinations, disorganized thinking, and disorganized or abnormal motor behavior.

Loose associations

A positive symptom characterized by the shift of ideas from one unrelated topic to another.

Circumstantiality

A delay in reaching the point of a communication because of unnecessary and tedious details.

Tangentiality

The inability to get to the point of communication due to the introduction of many new topics.

Haloperidol

A 1st generation (typical) antipsychotic medication used for positive symptoms only; associated with EPS.

Risperidone

A 2nd generation (atypical) antipsychotic used for both positive and negative symptoms; can cause weight gain and increased glucose.

Benztropine

An anticholinergic medication used to treat Extrapyramidal Symptoms (EPS).

NMS (Neuroleptic Malignant Syndrome)

A condition that can be caused by both 1st and 2nd generation antipsychotic medications.

Columbia Suicide Scale

An assessment tool used to monitor the risk of suicide, which affects 20-40% of patients with schizophrenia.

Psychological treatments

Non-pharmacological interventions including group therapy, behavior therapy, and individual psychotherapy.

Social treatments

Non-pharmacological interventions including family therapy, social skills therapy, and milieu therapy.

Haloperidol

$1^{st}$ gen (typical) antipsychotic used for positive symptoms only; side effects include EPS.

Risperidone

$2^{nd}$ gen (atypical) antipsychotic used for both positive and negative symptoms; side effects include weight gain and increased glucose.

Benztropine

An anticholinergic medication used to treat extrapyramidal symptoms (EPS).

NMS

Neuroleptic Malignant Syndrome; a complication that can be caused by both $1^{st}$ and $2^{nd}$ generation antipsychotics.

colombia Suicide scale

A tool used for suicide risk concerns in patients with Schizophrenia, where $20-40\%$ attempt suicide.

Vesicoureteral Reflux

Backwards urine flow that carries bacteria towards the kidneys.

Uncomplicated UTI

An infection in the urinary tract usually involving only the bladder, treated with a short antibiotic course.

Complicated UTI

An infection involving underlying factors like catheterization, pregnancy, or diabetes; treated with a longer antibiotic course of $7-21$ days.

Donning PPE Order

$1.$ gown, $2.$ mask, $3.$ goggles, $4.$ gloves.

Doffing PPE Order

$1.$ gloves, $2.$ goggles, $3.$ gown, $4.$ mask.

Pyelonephritis

A rare but serious complication where a UTI reaches the kidneys.

Urosepsis/bacteremia

A complication where a UTI spreads from the urinary tract into the blood stream.

Cystoscopy

A diagnostic procedure used for recurrent UTIs, calculi, diverticula, or strictures.

Etiologic Agent

The first link in the chain of infection, such as a bacteria or virus.

Airborne Precautions

Precautions for mma, chicken pox, zoster, or tuberculosis requiring a private room and an $N95$ respirator or higher.

Droplet Precautions

Precautions for flu, COVID, or meningitis; requires a surgical mask.

Contact Precautions

Precautions for MDROs (MRSA, VRE), C.Diff, or scabies; requires gown and gloves.

Premorbid phase

The first phase of schizophrenia characterized by shy and withdrawn behavior and poor peer relationships.

Prodromal phase

The phase of schizophrenia lasting a few weeks to years where social withdrawal and functional impairment become apparent.

Waxy flexibility

A positive symptom of schizophrenia involving passive yielding of all movable body parts to any effort made at placing them in tertentu positions.

Anergia

A deficiency of energy.

Loose associations

A positive symptom where ideas shift from one unrelated topic to another.

Normalized deviation

Unacceptable norms forming over time, such as not following proper gel in/gel out or PPE requirements.

Competence

Having sufficient capacity and ability to make reasoned decisions.

Tort

When someone carries out an act or fails to carry out an act that results in injury or harm to the patient.

Near miss event

An error of commission or omission that could have harmed the patient, but serious harm did not occur because the error was caught.

Sentinel event

An unexpected occurrence involving death or serious physical or psychological injury that requires immediate investigation.

PSDA (patient self determination Act)

Act that informs patients of their right to make decisions regarding care and the right to refuse treatment.

Assault

Threatening to touch someone without their consent.

Battery

Touching someone without their consent.

Libel

Written defamation of character using false statements.

Primary osteoporosis

Bone loss associated with age or postmenopausal status, where falling estrogen accelerates bone resorption.

Disuse Syndrome

Signs and symptoms that result from inactivity or a sedentary lifestyle.

Rheumatoid arthritis

A chronic, systemic, autoimmune inflammatory disease involving joint swelling and tenderness.

Functional Ability

An individual's ability to perform normal ADLs to meet basic needs across cognitive, social, physical, and emotional dimensions.

Instrumental ADLs

Complex skills for independent community living, such as managing money, grocery shopping, or medication management.

Bradykinesia

One of the $4$ cardinal motor symptoms of Parkinson's characterized by slow or absent movement.

Anosmia

The loss of the sense of smell, which can appear years before motor symptoms in Parkinson's.

Deep Brain Stimulation (DBS)

Surgical management for Parkinson's where electrodes deliver current to reduce dyskinesias and tremors.