A client with Paget's disease experiences frequent headaches. Which cranial finding should the nurse assess for during the neurological examination?
Nystagmus
Diplopia
Papilledema
Enlarged frontal bossing
The Correct Answer is D
Enlarged frontal bossing (prominent forehead) is a cranial finding often seen in clients with Paget's disease due to increased bone growth in the skull bones. This can cause pressure and contribute to headaches.
a. Nystagmus: Nystagmus is an involuntary, rhythmic movement of the eyes and is not directly associated with Paget's disease.
b. Diplopia: Diplopia, or double vision, is not a typical finding in Paget's disease. It may be related to other neurological or ocular conditions.
c. Papilledema: Papilledema is swelling of the optic disc due to increased intracranial pressure. While headaches can be associated with Paget's disease, papilledema is not a common manifestation of the condition.
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Correct Answer is C
Explanation
Individuals with Paget's disease should be encouraged to engage in walking and low-impact exercises to promote bone health. These activities are less likely to cause fractures or stress on the bones while still supporting bone strength and density.
a. Participating in high-impact sports: High-impact sports can put excessive stress on the bones and increase the risk of fractures in individuals with Paget's disease. It is not recommended.
b. Limiting physical activity to avoid fractures: While excessive physical activity may need to be moderated to prevent fractures, limiting all physical activity is not advisable. Moderate exercise is essential for overall health and bone strength.
d. Heavy weightlifting: Heavy weightlifting can increase the risk of fractures in individuals with Paget's disease. It is not recommended, as it can put excessive stress on the bones.
Correct Answer is D
Explanation
Bisphosphonate medications are commonly prescribed for Paget's disease to slow down bone resorption and promote more balanced bone remodeling. Taking bisphosphonates with a full glass of water or milk helps ensure proper absorption and reduce the risk of gastrointestinal irritation.
a. "Paget's disease is a type of cancer that affects the bones." This statement is incorrect. Paget's disease is not a type of cancer but a chronic, non-cancerous condition characterized by abnormal bone remodeling.
b. "This condition is caused by a deficiency in vitamin D." This statement is incorrect. While vitamin D plays a role in bone health, Paget's disease is primarily a result of genetic factors that lead to abnormal bone remodeling.
c. "I should avoid weight-bearing exercises to prevent fractures." This statement is incorrect. Moderate weight-bearing exercises, under healthcare provider guidance, can help maintain bone strength and reduce the risk of fractures in individuals with Paget's disease.
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