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Reported by

Nacito, Julie Ann T.
& Tiongson, Annie Joy M.
Osteoporosis

 "porous bones"
 from Greek: ostoun meaning "bone" and
poros meaning "pore“
 is a progressive bone disease that is
characterized by a decrease in bone mass and
density which can lead to an increased risk
of fracture.
Prevalence

 Is the most prevalent bone disease in the world
 more than 10M Americans have osteoporosis
 It is projected that one of every two caucasian
women one of every five men will have an
osteoporosis related fracture.
 The consequence of osteoporosis is bone fracture

 Peak adult bone mass is achieved between the
ages of 18 and 25 years in both females and
males
 Failure to develop optimal peak bone mass
during childhood, adolescence, and young
adulthood contributes to the development of
osteoporosis
 It is affected by genetic factors, nutrition,
physical activity, medications, endocrine status
and general health.
Risk factors
GENETICS
 Caucasian or Asian
 Female
 Family history
 Small Frame
Predispose to
low
bone mass
AGE
 Post menopause
 Advanced age
 Low testosterone in men
 Decreased calcitonin

Hormones (estrogen,
calcitonin and
testosterone) inhibits
bone loss
NUTRITION
 Low calcium intake
 Low vita D intake
 High phosphate
(carbonated beverages)
 Inadequate calories
Reduces nutrients
needed for bone
remodelling
PHYSICAL EXERCISE
 Sedentary
 Lack of weight-bearing
exercise
 Low weight and body
mass index
Bones needs
STRESS for bone
maintenance
LIFE STYLE CHOICES
 Ceffeine
 Alcohol
 Smoking
 Lack of exposure to sunlight
Reduces
osteogenesis in
bone
remodelling
MEDICATIONS
 Corticosteroids
 Antiseizure meds
 Heparin
 Thyroid hormone
CORMOBIDITY
 Anorexia nervosa
 Hyperthyroidism
 Malabsorption syndrome
 Renal failure
Affects calcium
absorption and
metabolism
How does it happen?



On the board pls.
Julie it’s your turn to shine!
ASSESSMENT & DIAGNOSTICS
 Osteoporosis may be undetectable on routine x-
rays until there has been 25%-40%
demineralization resulting in radiolucency of the
bones.
 DUAL ENERGY X-RAY ABSORPTIOMETRY (DXA)
Which provides information about BMD at the spine
and hip
 BMD testing is recommended for all women older
than 65 years of age and men older than 70 yrs.
It is also useful in identifying osteopenic and
osteoporotic bone in assessing response to therapy.
MEDICAL MANAGEMENT
 A diet rich in calcium and vita D throughout life,
with an increased calcium intake during
adolescence, young adulthood and the middle
years protects against skeletal demineralization
 Such diet includes 3 glasses of skim or whole vita
D-enriched milk or other foods high in calcium
daily (cheese and other dairy products, steamed
broccoli, canned salmon with bones)
 Regular weight-bearing exercise promotes bone
formation. 20-30 minutes of aerobic exercise for 3
times or more per week.

PHARMACOLOGIC THERAPY
 The first line medications used to treat and
prevent osteoporosis include calcium
(Caltrate,Citracal) and vitamin D supplements
and bisphosphonates taken with meals or with
beverage high in vita C to promote absorption.
 Common side effects of calcium supplements are
abdominal distention and constipation.
 Vitamin D and calcium supplements should not
be taken the same day with the bisphosphonates
and its side effects includes gastrointestinal
symptoms (dyspepsia, nausea, flatulence,
diarrhea, constipation)

 Clients who take bisphosphonates must take this
on an empty stomach with full glass of water and
must sit upright for 30-60 minutes after
administration.
 Selective estrogen receptor modulators such as
raloxifene (Evista) reduces the risk of osteoporosis.
FRACTURE MANAGEMENT
 Fractures on the hip that occur as consequence
of osteoporosis are managed surgically by joint
replacement or by closed or open reduction
with internal fixation.
NURSING DIAGNOSIS
 Deficient knowledge about osteoporotic
process and treatment regimen
 Acute pain r/t fracture and muscle spasm
 Risk for constipation r/t immobility or
development of ileus (intestinal
obstruction)
 Risk for injury: additional fracture r/t
osteoporosis
NURSING INTERVENTION
 Relieve back pain resulting from compression
fracture by resting in bed in a supine or side-lying
position several times a day.
 Knee flexion increases comfort by relaxing back
muscles
 Intermittent local heat and back rubs promote
muscle relaxation
 Instruct the patient to move the back as a unit
and to avoid twisting
 Teach also the patient about body mechanics

Encourage the patient to do
walking exercises
Daily weight-bearing activity
outdoor
Avoid sudden bending, jarring, and
strenuous lifting.
Improving Bowel Elimination
 Advice high fiber diet
 Increase fluid intake
 It is also a must to monitor the I&O and
the bowel sounds and activity
THANK YOU
FOR LISTENING
^_^