Osteoporosis

The nurse is assessing a postmenopausal client. Which question should the nurse ask to assess for signs of osteoporosis? -"Have you experienced any palpitations?" -"Are you having any low back pain?" -"Are you having problems with swelling in your feet?" -"Is constipation a problem for you?"

-"Are you having any low back pain?" A client with osteoporosis will often present with low back pain as well as a decrease in height. Palpitations, constipation, and swelling are not early signs of osteoporosis.

The nurse is caring for an older adult client who is taking calcium for the treatment of osteoporosis. Which statements will the nurse include when educating the client about this medication? (Select all that apply) -"The most common adverse effect is hypercalcemia caused by taking too much of the supplement." -"Oral calcium supplements are best taken on an empty stomach." -"Adults 50 years of age and over should obtain at least 500 to 750 mg per day of elemental calcium." -"If you have a condition called ventricular fibrillation, this medication might help." -"Report symptoms of weakness, increased urination, and thirst."

-"The most common adverse effect is hypercalcemia caused by taking too much of the supplement." -"Report symptoms of weakness, increased urination, and thirst." Calcium gluconate and other calcium compounds are used to treat and prevent osteoporosis. Oral calcium supplements are best taken with meals or within 1 hour following meals. It is recommended that adults 50 years of age and over obtain at least 1000 to 1200 mg per day of elemental calcium. The most common adverse effect is hypercalcemia caused by taking too much of the supplement. Symptoms include lethargy, drowsiness, weakness, headache, anorexia, nausea and vomiting, increased urination, and thirst. Calcium supplementation is contraindicated in clients with ventricular fibrillation.

A nurse is performing health screenings on clients at a health fair. Which of the following clients have a risk for osteoporosis? (Select all that apply) -A 40yr old client who takes prednisone for 4 months -A 30yr old client who jogs 3 miles daily -A 45yr old client who takes phenytoin for seizures -A 65yr old client who has a sedentary lifestyle -A 70yr old client who has smoked for 50 years

-A 40yr old client who takes prednisone for asthma -A 45yr old client who takes phenytoin for seizures -A 65yr old client who has a sedentary lifestyle -A 70yr old client who has smoked for 50 years Prednisone affects the absorption and metabolism of calcium (as does phenytoin) when taken for an extended time (at least 3 mo.). Bones need the stress of weight bearing activity for bone rebuilding and maintenance. Smoking decreases osteogenesis.

A nurse is asked to speak to a group of women at a community health day about osteoporosis. Which of the following should she include when discussing the risk factors for osteoporosis? -Obesity -Late menopause -Multi-parity -Cigarette smoking

-Cigarette smoking Risk factors for osteoporosis include advanced age, low body weight, excess alcohol consumption, cigarette smoking, family history of hip fracture or prior fracture, and long-term use of glucocorticoids.

A nurse is providing dietary teaching about calcium-rich foods to a client to has osteoporosis. Which of the following foods should the nurse include in the instructions? -White bread -Kale -Apples -Brown rice

-Kale Green leafy vegetables (broccoli, kale, mustard greens) are good sources of calcium. White bread and brown rice are good sources of carbohydrates. Apples are a good source of fiber.

A nurse is admitting an adult client who has suspected osteoporosis. Which of the following findings are risk factors for osteoporosis? (Select all that apply) -History of consuming one glass of wine daily -Loss in height of 2 in (5.1 cm) -Body mass index (BMI) of 18 -Kyphotic curve at upper thoracic spine -History of lactose intolerance

-Loss in height of 2 in (5.1 cm) -Body mass index (BMI) of 18 -Kyphotic curve at upper thoracic spine -History of lactose intolerance The loss of 2 inches of height is suggestive of osteoporosis due to fractures of the vertebral column. A client who has a BMI of 18 is at risk of developing osteoporosis due to low body weight and thin body build, suggesting decreased bone mass. Kyphosis curve is highly suggestive of osteoporosis due to fractures of the vertebrae causing the curve. Lactose intolerance is highly suggestive of osteoporosis due to possible lack of calcium intake.

A nurse is providing care for a client who had a vertebroplasty of the thoracic spine. Which of the following actions should the nurse take? -Apply heat to the puncture site -Place the client in a supine position -Turn client every 1 hr -Ambulate the client within the first hour post-procedure

-Place the client in a supine position The client should remain in a supine position with the bed flat for the first 1 to 2 hr following the procedure to allow for hardening of the cement. The client should have cold therapy applied to the puncture site to decrease bleeding and swelling following the procedure.

A nurse is planning discharge teaching on home safety for an adult client who has osteoporosis. Which of the following information should the nurse include in the teaching? (Select all that apply) -Remove throw rugs in walkways -Use prescribed assistive devices -Remove clutter from the environment -Wear soft-bottomed shoes -Maintain lighting of doorway areas

-Remove throw rugs in walkways -Use prescribed assistive devices -Remove clutter from the environment -Maintain lighting of doorway areas Removing throw rugs, using prescribed assistive devices, removing clutter, and providing good lighting can prevent a fall and bone fracture.

A nurse is providing education for a group of seniors at a health fair concerning osteoporosis. Which of the following lifestyle modifications should the nurse recommend to decrease the risk of fracture? (Select all that apply) -Weight bearing exercise, including regular walks -Tobacco cessation -Increase dietary protein consumption -Increased yellow or orange vegetable consumption -Consumption of red instead of white wine when drinking alcohol

-Weight bearing exercise, including regular walks -Tobacco cessation A high protein diet is not associated with reduced risk. Yellow and orange vegetables are high in vitamin A, not vitamin D; vitamin A does not contribute to the absorption of dietary calcium. Type of alcohol is inconsequential in respect to amount consumed.