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What does Fosamax do
Inhibits osteoclasts
Age related hormone changes that have an effect on osteoporosis (list 3)
1: Decreased calcitonin - Increased bone resorption 2: Decreased estrogen 3: Increased parathyroid - Increased bone resportion
Diagnosis of Osteoporosis (list 2)
1: Early diagnosis is hard - no s/s until significant bone loss. 2: X-Ray shows after >30% bone loss (hand, wrist, radius)
Things to avoid with Osteoporosis (promote Ca++ secretion) (list 6)
1: Excess fiber 2: Protein 3: Caffeine 4: ETOH 5: Smoking 6: Soft drinks
Bones most often affected by osteoporosis (list 5)
1: Femoral neck 2: Wrists 3: Vertebrae 4: Humeral neck 5: Occasionally jaw & teeth
How must Fosamax be given (list 2)
1: Give alone & on empty stomach with full glass of H20 2: Must sit upright x 30 min after (Prevents serious GI distress)
Protection from fractures (list 5)
1: Good body mechanics 2: Avoid heavy lifting, straining or vibrations 3:: Home fall safety 4: Assistive devices - canes, walkers 5: Back brace or corset may help
Clinical manifestations of osteoporosis (list 4)
1: Low/Mid thoracic back pain (increases on sitting/standing) 2: Kyphosis (Dowager's hump) 3: Lumbar lordosis 4: Loss of height r/t vertebral collapse
Patient teaching for Osteoporosis (list 4)
1: Safety (falls) 2: Meds 3: Dietary (1200 mg Ca++ w/Vit D, spinach, kale) 4: Activity (weight bearing)
Ca++ foods (list 4)
1: leafy greens 2: canned fish with bones 3: Nuts 4: Legumes
What does calcitonin do
Inhibits osteoclasts & resorption
Medications for osteoporosis (list 6)
1: Ca++ (1200 mg/day) 2: Vit D (400 IU/day) 3: ERT (estrogen replacement therapy) 4: Evista (estrogen agonist - no estrogen side effects) 5: Calcitonin 6: Fosamax
Risk factors for osteoporosis (list 7)
1: Decreased Ca++ intake 2: Decreased physical activity 3: Estrogen depletion 4: Race (Caucasian, Asian>Black) 5: Female > Male 6: Petite, small thin frame 7: ETOH, smoking, caffeine
A nurse is performing health screenings at a health fair. Which of the following clients are at risk for osteoporosis? (Select all that apply.) A. A 40‑year‑old client who takes prednisone for asthma B. A 30‑year‑old client who jogs 3 miles daily C. A 45‑year‑old client who takes phenytoin for seizures D. A 65‑year‑old client who has a sedentary lifestyle E. A 70‑year‑old client who has smoked for 50 years
A. CORRECT: Prednisone affects the absorption and metabolism of calcium and places the client at risk for osteoporosis. C. CORRECT: Phenytoin affects the absorption and metabolism of calcium and places the client at risk for osteoporosis. D. CORRECT: A sedentary lifestyle places the client at risk for osteoporosis because bones need the stress of weight bearing activity for bone rebuilding and maintenance. E. CORRECT: Smoking increases the risk for osteoporosis because it decreases osteogenesis.
A nurse is planning discharge teaching on home safety for an older adult client who has osteoporosis. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Remove throw rugs in walkways. B. Use prescribed assistive devices. C. Remove clutter from the environment. D. Walk with caution on icy surfaces. E. Maintain lighting of doorway areas.
A. CORRECT: Removing throw rugs in walkways can help to prevent a fall and bone fracture. B. CORRECT: Using prescribed assistive devices can help to prevent a fall and bone fracture. C. CORRECT: Removing clutter from the environment can help to prevent tripping, falling, and a bone fracture. E. CORRECT: Good lighting in doorway areas can prevent a fall and bone fracture.
What is osteoporosis
An abnormal increase in bone resorption that leads to decreased bone density.
A nurse is providing care for a client who had a vertebroplasty of the thoracic spine. Which of the following is an appropriate action by the nurse? A. Apply heat to the puncture site. B. Place the client in a supine position. C. Turn the client every 1 hr. D. Ambulate the client within the first hour postprocedure.
B. CORRECT: The client should remain in a supine position with bed flat for the first 1 to 2 hr following the procedure to allow for hardening of the cement.
A nurse is admitting an older adult client who has suspected osteoporosis. Which of following is an expected finding? (Select all that apply.) A. History of consuming one glass of wine daily B. Loss in height of 2 in (5.1 cm) C. Body mass index (BMI) of 21 D. Kyphotic curve at upper thoracic spine E. History of lactose intolerance
B. CORRECT: The loss of 2 inches of height is suggestive of osteoporosis due to fractures of the vertebral column. C. CORRECT: A client who has a BMI of 21 is at risk of developing osteoporosis due to low body weight and thin body build, suggesting decreased bone mass. D. CORRECT: Kyphosis curve is highly suggestive of osteoporosis due to fractures of the vertebrae causing the curve. E. CORRECT: Lactose intolerance is highly suggestive of osteoporosis due to possible lack of calcium intake.
A nurse is providing dietary teaching about calcium‑rich foods to a client who has osteoporosis. Which of the following foods should the nurse include in the instructions? A. White bread B. White beans C. White meat of chicken D. White rice
B. CORRECT: White beans should be included in the teaching because they are a good source of calcium.
Diagnositic test for Osteoporosis
Bone Densitometry - noninvasive, minimal radiation. Given after 35 y/o
Primary (Senile) Osteoporosis
Bone mass peaks - age 30 y/o then declines
Which of the following clients is at greatest risk for osteoporosis and needs to be educated about the condition by the nurse? A: An overweight African-American woman approaching menopause B: A teenaged male with asthma C: A small-framed, thin white woman approaching menopause D: A young male athlete who plays contact sports and is constantly injured
C: A small-framed, thin white woman approaching menopause
Secondary Osteoporosis
R/T meds or another disease (Prednisone, tetracycline, aluminum containing antacids, some anticonvulsants, diuretics, thyroid) R/T Hyperthyroidism, Cushing's syndrome
What do they need to take with Ca++ supplements
Vitamin D
Activity for Osteoporosis
Weight bearing exercise -Aerobics 3X a week -Walking -Avoid forward flexing -Analgesics if pain affects exercise
