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OSTEOPOROSIS

DESCRIPTION NURSING DIAGNOSES BY PRIORITY


● Systemic skeletal disease characterized by low bone 1. Impaired physical mobility related to bone loss
mass and microachriectual deterioration of bone tissue 2. Imbalanced nutrition: less than body requirement
that leads to increased bone fragility and susceptibility related to inadequate calcium and vitamin D
to fracture 3. Deficient knowledge related to lack of exposure to
● Categories of osteoporosis: information regarding medication, dietary
○ Normal modifications and safe activity program
■ Value for bone mineral content
(BMC) is not more than 1.0 standard NURSING MANAGEMENT/ INTERVENTION
deviation (SD) below young adult ● Promote understanding of osteoporosis and the
mean value treatment regimen
○ Low bone mass (osteopenia) ● Advise patient to rest in bed in a supine or side lying
■ Value for BMC lied between 1.0 to position several times a day to relieve pain
2.5 SD below young adult mean ● Encourage the patient to intake adequate calcium and
value vitamin d
○ Osteoporosis ● Encourage walking and regular weight bearing
■ BMC is more than 2.5 SD below the exercises to enhance the production of vitamin D
young adult value ● Encourage the patient to avoid tobacco and alcohol
○ Severe osteoporosis ● Instruct the patient regarding estrogen replacement
■ BMC is more than 2.5 SD below the therapy
young adult value and presence of ● Inform the patient regarding dietary calcium and
one or more fragility fracture vitamin D
● Administer food high in fiber and increase fluids to
FOCUS ASSESSMENT (SIGNS AND SYMPTOMS) prevent constipation
● Severe back pain caused by fractures of collapsed
vertebra MEDICAL/ SURGICAL INTERVENTION
● Loss of height ● Joint replacement
● Progressive vertebral deformities ○ Replace all or part of a joint with a prosthesis
● Changes in appearance ● Closed or open reduction with internal fixation
○ Open- implants to guide the healing process of
DIAGNOSTIC AND LABORATORY TEST a bone
● Bone density scan ○ Closed- to set or reduce a broken bone without
○ Used to measure bone mineral density surgery
○ Commonly performed using dual energy x-
ray absorptiometry (DXA) DRUG ANALYSIS
● Calcium and vitamin D supplements
RISK FACTORS ● Bisphosphonates
● Hereditary ○ Increase bone mass and decrease bone loss by
● Low body weight (<127 lbs) inhibiting osteoclast function
● Prolonged premenopausal amenorrhea or early ■ Alendronate, risedronate,
menopause ibandronate, zoledronic
● Inadequate physical activity ● Monoclonal antibody medications
● Low intake of dietary calcium ○ Decrease bone resorption, increase BMD and
● Suboptimal level of vitamin D reduce the risk of fracture
● Smoking and alcohol intake ○ Administered intradermally every 6 months
○ Suppress osteoblast activity ■ Denosumab
● Certain medication such as: ● Hormone related therapy
○ Steroids, thyroid hormone, anti- convulsants, ○ Help maintain bone density in menopausal
calcium channel blockers, NSAIDS women
● Certain medical conditions such as: ■ Estrogen, raloxifene
○ Celiac disease, IBD, cancer, rheumatoid ● Calcitonin
arthritis ○ Inhibits osteoclasts thereby reducing bone loss
● Fragility fracture resulting from low trauma and increasing bone mineral density
● Osteopenia ● Bone building medication
○ Used when other common treatment cannot be
tolerated
■ Teriparatide- stimulates new bone
growth
■ Abaloparatide
■ Romosozumab

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