Osteoporosis Flashcards
Osteoporosis
A chronic progressive metabolic disease characterised by low bone mass and structural deterioration of bone tissue, leading to increased bone fragility
Pathophysiology
Peak bone mass occurs mostly by the early 30s and then begins to decline
Decreased calcitonin and oestrogen with age
Normally bone formation and resorption rate is greater i resulting in loss of total bone mass
Bone becomes porous, brittle and fragile and fracture under stress
Clinical manifestation and
Asymptomatic initially
Pain
Fracture to him, vertebrae or wrist
Micro fractures of spine lead to loss of stature and kyphosis
Risk factors of osteoporosis
Genetics Age Nutrition Physical inactivity Lifestyle choices Medications Comorbidity Female Smoking Excessive alcohol Low testosterone or low oestrogen levels
Diagnosis
Bone mineral density test(bmd) for women over 65 and men over 70
Routine xray show osteoporosis if mode than 25 -45 percent demineralisation has occur
Laboratory studies
Reuslts
Normal
Osteopenia
Osteoporosis
Normal
1 to -1 t score
You should ensure you have adequate calcium enough vit d and that you do regular exercise
These are all important factors for maintaining healthy bones
Osteopenia
-1 to -2.5
Risk of developing osteoporosis fracture risk is low to medium
Take immediate action to minimise further bone loss
Your doctor will ensure calcium and vit d
The doctor will monitor your bone density with a follow uo dxa scan after 1-2 years
Osteoporosis
-2.5 or lower
Fracture risk is high
Your doctor will start treatment with specific osteoporosis medicine and ensure adequate calcium and vit d
Your doctor should discuss possible causes and risk factor
Collaborative management
Adequate nutrition especially calculated and vit d Calcium intake Exercise Fracture prevention Fracture management Medication
Pharmacological therapy
Bisphosphonates - alendronate - risodronate - ibandronatw Calcium and vit d Calcitoninc: calcitrol Selective oestrogen modulators: tamixofen Teriparatide : fortes
Care for the patient with osteoporosis : assesment
Occurrence of osteoporosis and osteopenia Family history Previous fractures Dietary consumption if calcium Onset menopause Alcohol skoking and caffeine
Nursing problems
Deficient knowledge about osteoporotic process
Acute pain due to fracture and muscle spans
Risk of constipation due to immobility abs side effect of meds
Risk of injury : additional fracture due to osteoporosis
Knowledge. Deficit about osteoporotic process and treatment regimen
Education
- factors influencing the development
- interventions to arrest or slow the process
- measures to relieve symptoms
Pain related to fracture and muscle spasm
Relieve pain
- frequent bed rest during the day
Local heat and massage
Lumbar support brace to be worn during ambulation
Patient increase activities as pain lowers
Risk for injury related to osteoporosis
Prevent further injury
- teach about physical activity to strengthen muscles and improve balance and prevent disuse atrophy
And retard progressive bone demineralisation
- regular walks
Sunshine
Daily weight activities
Gerontologic considerations
Prevention of falls
Changes in the environment
Hip procetors
Preventing osteoporosis and lifestyle medicane
Aim of treatment is preventing further bone loss and development of fracture
- balanced diet high calcium
- use of calcium supplements
- weight training
- environment assessment for hazards to prevent falls
