Transcript for:
Understanding Osteoporosis: Causes and Management

Title: osteoporosis URL Source: blob://pdf/561b7fc2-fc0e-4f2a-8665-78f64134eaeb Markdown Content: OSTEOPOROSIS PATHOPHYSIOLOGY > 2 Osteoporosis is a common chronic metabolic bone disorder resulting in low bone density. Osteoporosis occurs when the rate of bone resorption (osteoclast cells) exceeds the rate of bone formation (osteoblast cells) resulting in fragile bone tissue and can lead to fractures. ETIOLOGY OF OSTEOPOROSIS Primary Causes Aging - greater than 50 y/o Ethnicity - Asian American and White American Sex - Females especially after menopause or ovary removal (both cause decline in estrogen) Decreased calcium intake and low Vit D High phosphorus = low calcium Limited protein Tobacco use Secondary Causes Chronic Kidney Disease Chronic Obstructive Pulmonary Disease (COPD) Multiple Myeloma Medications - Anticonvulsants (phenytoin) and Loop diuretics (furosemide) Endocrine disorders (hyperparathyroidism) Rheumatoid Arthritis Malabsorption Syndromes > 3 ASSESSMENT FINDINGS (SIGNS AND SYMPTOMS) Reduced height of 5 to 7.5 cm (2 to 3 inches) Acute back pain after lifting or bending (worse with activity, relieved by rest) Restriction in movement and spinal deformity History of fractures (wrist, femur, thoracic spine) Thoracic (kyphosis) of the dorsal spine Pain upon palpation over affected area DIAGNOSTIC PROCEDURES Radiography Dual -energy x -ray absorptimetry (DEXA) Peripheral Quantitative Ultrasound (pQUS) Quantitative Computed Tomography Magnetic Resonance Imaging (MRI) Magnetic Resonance Spectroscopy (MRS) > 5 LABORATORY TESTS Blood calcium, vitamin D, phosphorus, hematocrit, ESR, and alkaline phosphatase levels are drawn to rule out other metabolic bone diseases (Pagets disease or osteomalacia). Blood calcium and vitamin D should be checked yearly for females at high risk and yearly after age 50 for males at high risk. > 6 ## THERAPEUTIC ## PROCEDURES - Orthotic Devices - Joint Repair or Joint Arthroplasty - Vertebroplasty of Kyphoplasty NURSING MANAGEMENT Encourage weight bearing exercises Take calcium and Vit. D supplements with food Reinforce the need for exposure to Vit. D Assess home environment for safety Instruct regarding dietary calcium food sources > 8 CLIENT EDUCATION Limit caffeine, alcohol, and carbonated beverages Consume adequate amounts of protein, Vit K., magnesium, and other trace minerals Avoid slippery surfaces Wear rubber bottomed shoes Exercises: o Isometric exercises o Avoid jarring activities and strenuous lifting > 9 # PHARMACOLOGY ## BISPHONATES ## -Alendronate ## -Ibandronate ## -Risedronate ## -Zoledronic Acid ## -Pamidronate NON -PHARMACOLOGICAL ## INTERVENTIONS ## Vitamins ## -Calcium ## -Vitamin D OSTEOPOROSIS COMPLICATIONS Fractures due to low mineral bone density Thoracic(Kyphosis) of the dorsal spine > 12 # Rich in Vitamin D Protein Calcium Gerontologic # Concerns 14 ThePhoto by PhotoAuthor is licensed under CCYYSA. ThePhoto by PhotoAuthor is licensed under CCYYSA. ThePhoto by PhotoAuthor is licensed under CCYYSA. ThePhoto by PhotoAuthor is licensed under CCYYSA. EXERCISE AND WEIGHT TRAINING Exercise 3x a week. Exercise to include weight training.