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Outline
Overview
Pathophysiology
Bone is a living tissue that is constantly breaking down and being replaced. Osteoporosis happens when growth of new bone does not keep up with the breaking down of old bone. This makes the bones very brittle and fragile. Primary osteoporosis is a result of the normal aging process, while secondary osteoporosis is a result of another disease process.
Etiology
Bone regeneration normally takes place much faster than the deterioration process and the bones grow in mass reaching a peak in a person’s 20s. As people age, the breaking down process becomes faster than the regeneration process. The amount of bone mass at the peak can partly determine the likelihood of developing osteoporosis. There are many risk factors. It is most common in older women, due to a decrease in estrogen, as well as people taking corticosteroids or with a decreased dietary intake of calcium.
Desired Outcome
The goal of treatment is to address the underlying causes and prevent fractures.
Osteoporosis Nursing Care Plan
Subjective Data:
- Bone Pain
There are typically no symptoms in the early stages of bone loss
Objective Data:
- Loss of height over time
- Stooped posture
- Kyphosis of the spine
- Bone fractures, especially hip/pelvis
- Pathologic fractures
- Occur without trauma
Nursing Interventions and Rationales
- Assess and manage pain
- Initiate fall precautions to prevent injury
- Support fracture stabilization
- Administer medications appropriately
- Bisphosphonates (alendronate, ibandronate)
- Hormone therapy
- Biologic drugs (denosumab)
- Monitor respiratory status and signs of fat embolism
- Assist with repositioning
- Assist with ROM activities
- Consult physical and occupational therapy as appropriate
- Nutrition and lifestyle education
- Healthy diet, increase calcium intake
- Exercise as tolerable in safe environment
- Quit smoking
- Limit or avoid alcohol
- A healthy diet high in calcium and vitamin D can help prevent skin breakdown and exercise promotes circulation and healing.
- Weight-bearing exercises can improve the strength of muscles around weak bones/joints as well as increase bone density to reduce the risk of fractures.
- Smoking increases the rate of bone loss.
- Limit alcohol to two drinks per day as it can decrease bone formation and increase the risk of falls.
References
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