Osteoporosis Davis Advantage

The nurse is talking with a client who asks why a traditional x-ray cannot be used to screen for osteoporosis. The nurse would give which explanation to the client's question? "It can be used with equal results, but with a dual-energy x-ray absorptiometry scan, we don't have to expose you to as much radiation." "Great question. Let me check with your healthcare provider." "Early bone demineralization cannot be detected by an x-ray." "The healthcare provider orders the test that your insurance will cover."

"Early bone demineralization cannot be detected by an x-ray."

Min, a 55-year old postmenopausal Asian female, is visiting her healthcare provider for an annual physical. She is approximately 50 pounds overweight. Min states that she is a pack-a-day smoker and takes a daily multivitamin designed for women older than 50. When questioned by the healthcare provider, the client says she has never had bone mineral density testing.The nurse recognizes that that Min is at risk for osteoporosis because of which identified factors? Select all that apply. Gender Postmenopausal age Smoker Overweight Multivitamin use

Gender Postmenopausal age Smoker Overweight

Min tells the nurse she doesn't like any of the food and asks if there is another way to get vitamin D. What should the nurse suggest? Taking a multivitamin with vitamin D Sitting in the sun 15 minutes each day. Increasing the amount of table salt in her diet. Increasing weight-bearing exercises.

Sitting in the sun 15 minutes each day.

Min states she wants to lose weight and lead a healthier lifestyle. Which statement by the client requires additional teaching? "I can drink orange juice with Vitamin D added to help my body with the absorption of calcium." "My diet should focus on carbohydrates and fat with little protein." "I need to find an exercise activity to add to my life, along with a healthy diet to help manage my osteoporosis." "Along with a healthy diet, I should plan to take a multivitamin daily." Check Answer

"My diet should focus on carbohydrates and fat with little protein."

Min is upset by the new diagnosis and fearful of complications. What can the nurse tell her to provide some comfort? "Osteoporosis is genetic and you had no control over getting the disease." "Osteoporosis is curable and with proper treatment, you won't have residual effects." "Preventive lifestyle and medications can slow the progression of the disease." "Surgery is often a great alternative to living with the debilitating disease."

"Preventive lifestyle and medications can slow the progression of the disease."

The nurse is seeing a client with osteoporosis who started on a bisphosphonate last month to treat osteoporosis. The client states "Ever since I started taking that medicine, my stomach has really been bothering me." What is the nurse's best response? "Are you taking the medication with food? Sometimes taking the medication when you haven't eaten can cause an upset stomach." "What time of day are you taking the medicine? Most individuals have fewer side effects if the medicine is taken at bedtime." "When have you been taking the medication? The best time to take this medication is first thing in the morning, on an empty stomach." "Are you having any other stomach issues? Gastrointestinal issues are very common with this drug."

"What time of day are you taking the medicine? Most individuals have fewer side effects if the medicine is taken at bedtime."

Min is concerned that her pain level will worsen as she becomes more active. What would be an appropriate nurse response? "Your pain may increase, but you should strive for an active lifestyle." "Your pain should not increase when you add more activity in your life." "You cannot add pain medication to the medications that you take for osteoporosis." "You will find that your pain will decrease when you become more active."

"Your pain may increase, but you should strive for an active lifestyle."

The nurse is aware that a client's bone mineral density can be impacted by which factors related to aging? Select all that apply. An increase in progesterone levels A decrease in calcitonin levels An increase in estrogen levels An increase in the parathyroid hormone levels A decrease in prolactin levels

A decrease in calcitonin levels An increase in the parathyroid hormone levels

The nurse is speaking with a female client in her 40s who has a family history of osteoporosis and wants to know what dietary changes can decrease her risk of developing the disorder. What nutrient deficiencies have been correlated with osteoporosis? Select all that apply. Magnesium Calcium Vitamin E Vitamin D Potassium

Calcium Vitamin D

The nurse is reviewing the risks and benefits of opioid analgesic medication with the client with osteoporosis. Which of the following would the nurse include as side effects of opioids? Select all that apply. Constipation Respiratory depression Decreased uptake of calcium and vitamin D Drowsiness Esophagitis

Constipation Respiratory depression Drowsiness

The nurse is talking with a client who is confused about modifiable and non-modifiable risk factors for osteoporosis. Which of these are examples of modifiable risk factors? Select all that apply. Diet Weight Gender Lifestyle Ethnicity

Diet Weight Lifestyle

After the healthcare provider completes a fracture risk assessment screening, Min is scheduled for outpatient diagnostic testing to further evaluate her risk for osteoporosis. Which diagnostic test will be used to evaluate her bone density? Dual-energy x-ray absorptiometry (DEXA) Quantitative computerized tomography (qCT) Serum biochemical markers X-ray of the pelvis

Dual-energy x-ray absorptiometry (DEXA)

The nurse also suggests that Min increase the amount of vitamin D that she consumes to improve absorption. What foods should the nurse suggest? Select all that apply. Fish Milk Cereals Liver Egg whites

Fish Milk Cereals Liver

The nurse is assessing a client with a diagnosis of osteoporosis. What clinical manifestations would the nurse expect to observe? Select all that apply. Loss of height Pain relieved with activity and increased with rest Lordosis of the dorsal spine Previous fractures History of falls

Loss of height Previous fractures History of previous falls

Min is started on calcium but feels like the dose is too high. The nurse learns she is taking 1,200 mg each day in divided doses. What should the nurse suggest to Min? That dose is appropriate and should be continued. Decrease the dose by half. Clarify the dose with your provider. Increase the dose to 1,500 mg/day.

That dose is appropriate and should be continued.

The nurse is providing client teaching to a client suspected to have osteoporosis who is scheduled for a dual-energy x-ray absorptiometry (DEXA) scan. What would be included in the nurse's client teaching? The DEXA scan requires a barium swallow. The client should have a family member or friend present to drive the client home at the end of the scan. The DEXA scan will require an overnight hospital stay the night before the procedure. The DEXA scan is noninvasive and requires no preparation.

The DEXA scan is noninvasive and requires no preparation.

After the results of the DEXA scan, Min is started on a daily bisphosphonate. She states that she takes her daily medications at bedtime but has developed indigestion. What information should the nurse share with the client regarding this class of drug? Bedtime is an acceptable time to take the medication with a glass of milk. The medication should be taken at lunch with a large meal. The medication should be taken on an empty stomach first thing in the morning. The medication should be taken on an empty stomach 1 hour after a meal.

The medication should be taken on an empty stomach first thing in the morning.

The nurse is talking with a postmenopausal woman about how to prevent osteoporosis. Which of these lifestyle modifications could the nurse include? Select all that apply. Weight loss Muscle-strengthening exercises Avoiding excessive alcohol intake Increasing carbohydrate intake Smoking cessation

Weight loss Muscle-strengthening exercises Avoiding excessive alcohol intake Smoking cessation

Which populations have a high risk of osteoporosis? Select all that apply. Women younger than 50 Women of Asian descent Individuals with a family history of osteoporosis Individuals who are overweight Individuals who use tobacco

Women of Asian descent Individuals with a family history of osteoporosis Individuals who are overweight Individuals who use tobacco