DEFINITION  Osteoporosis is the most common metabolic bone disorder. Osteoporosis causes decreased bone mass and an increased risk of fracture. The disease is a significant cause of morbidity in the older adult. .

(corticosteroid and heparin). excessive caffeine ingestion. and hypocalcemia is believed to be a result of chronic inadequate dietary calcium ingestion. . glucocorticoid excess) prolonged bed rest. liver disease alcoholism. endocrine disorder (hyperthyroidism. hyperparathyroidsm. Other causative factors include medications. diabetes mellitus. cigarette smoking.ETIOLOGY     A multifactorial disease Has two major causes. calcium deficiency and estrogen levels deficiency Decreased estrogen levels are secondary to menopause.

post menopausal ad underwight. Women are eight time more likely to suffer from osteoporosis than men.  They are usually white.EPIDEMIOLOGY Approximately 15 to 20 million Americans are thought to suffer from osteoporosis. 90 % of women will have the disorder by the age of 75  .

Women over 40 also absorb less calcium from food. Bone mass peaks at approximately 35 years and then subsequently begins to decrease.PATHOPHYSIOLOGY         Osteoporosis is a reduction in bone mass with bone resorption exceed bone formation. resulting in decreased bone density. calcium is released from bone to reestablish the normal serum level. decrease renal calcium loss and increase calcium absorption in the GIT. After the age of 35 when the bone mass peaks and bones are strongest. . In the perimenopausal period  increased bone loss Bone remodeling or the process of bone breakdown and formation is a constant process Lack of stress to the bone causes demineralization of bone. bone resorption begins to exceed bone formation. With Hypocalcemia. Estrogen is though to decrease bone resorption.

CLINICAL MANIFESTATION        Height loss Dorsal Khyposis Back pain Fractures. most commonly of the twelfth thoracic and first lumbar vertebrae. Diagnostic studies include: x ray. however the finding will not definitive until approximately 30 % of bone mass to loss. may result from daily activity such as bending Women suffer from hip fractures two to three times more frequently than men. Bone most commonly affected: Wrist & Hip Vertebral crush fractures. .

Calcium supplement and vitamin D supplement may be prescribed to increase calcium absorption. and preventing fractures. premenopausal and 1500 mg postmenopausal. increasing bone formation. Studies indicate that the average daily adult calcium intake is 450 to 550 mg. Treatment measure are postmenopausal estrogen replacement therapy and adequate dietray or supplemental calcium.THERAPEUTIC MANAGEMENT      Management is aimed to decrease the process of bone resorption. . Recommendation for calcium supplementation are 1000 mg.

NURSING MANAGEMENT  ASSESSMENT Determinate of height loss dorsal khyposis presence of back pain. and occurrence of fractures or repeated fractures.  .  Address psychosocial issues: change in body image and limitation in vocational and recreational activities.

Knowledge deficit regarding disease process and treatment regimen . 5. 3.NURSING MANAGEMENT (Cont…)  1. 4. NURSING DIAGNOSES Chronic pain r/t decreased bone mass Impaired physical mobility r/t decreased bone mass and possible fractures Altered nutrition: less than body requirement r/t inadequate calcium and/or vitamin D intake Body fluid disturbance r/t body changes and disease process. 2.

NURSING MANAGEMENT (Cont…) PLANNING Nursing care is planned to attain the following patient outcomes: 1. Patient achieves management of pain 2. Patient functions within restricted mobility limitations 3. Patient develop a more positive self concept 5. Patient can explain the disease process and treatment regimen  . Patient attains and/or maintains optimal nutrition 4.

. Encourage to exposure to sunlight to optimize the body’s production of vitamin D. Provide much information about osteoporosis. Apply warm compresses to control pain Promote body mechanic and ROM Promote adequate and well balanced diet high in calcium and vitamin D and wise selection of calcium supplement.NURSING MANAGEMENT (Cont…)         IMPLEMENTATION Administer prescribed medication to control pain and monitor possible side effect Back bracing or other supportive devices may be used to decrease pain.