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Osteoporosis

Terms in this set (33)

Osteoporosis
a condition in which the bones become fragile and break easily
Osteoporosis Cause
lack of calcium
imbalance of bone growth and bone reabsorption
associated with aging
estrogen and testosterone decreased lvls
Pathophysiology of Osteoporosis
imbalance between osteoclast (destroys/resorbs bone) and osteoblast (builds bone) activity
Primary Osteoporosis
type 1- associated with menopause- estrogen loss
type 2- decreasing bone formation that deals with aging process
Dietary needs
high dairy/calcium diet, vitamin D
high protein diet can cause acidosis-BAD
dual energy x-ray absorptiometry (DEXA)
A highly accurate method of measuring body composition and bone mass and density using multiple low-energy X rays.
T-score of -1.0 to -2.5, reduced bone mass
osteopenia (low density)
T score below -2.5
osteoporosis
Alkaline Phosphatase (ALP)
may be elevated following a fracture
serum bone Gla protein (osteocalcin)
used as a marker of osteoclastic activity
indicator of bone turnover
Osteoporosis and children
spina bifida, cerebral palsy, immobilization, adolescent athletes
Osteoporosis and Pregnant Women
pregnancy and breastfeeding high demand on women's bones, needs even more calcium in diet
Osteoporosis and Elders
bone loss accelerates in women
visual impairment, loss of balance, neuromuscular dysfunction, dementia, immobilization, sleeping pills increases bone fracture risk
The nurse is assessing a postmenopausal client. Which question should the nurse ask to assess for signs of osteoporosis?
A) "Have you experienced any palpitations?"
B) "Are you having any low back pain?"
C) "Are you having problems with swelling in your feet?"
D) "Is constipation a problem for you?"
B
A nurse is conducting a health history on an older adult client. Which assessment finding indicates the client is at risk for osteoporosis?
A) Having a body mass index (BMI) that indicates obesity
B) Using glucocorticoids for 10 years because of a chronic lung disorder
C) Eating three to five servings of shrimp and liver per week
D) Drinking three glasses of skim milk daily
B
The nurse is planning care for a female adult client who is high-risk for developing osteoporosis. Which interventions will decrease the client's risk of developing this health problem? Select all that apply.
A) Increasing the intake of alcoholic beverages
B) Isometric exercise for at least 30 minutes three times per week
C) Weight-bearing exercises such as walking
D) Having a yearly dual-energy x-ray absorptiometry (DEXA) test
E) A diet with adequate amounts of calcium and vitamin D
C,E
The nurse identifies the nursing diagnosis Imbalanced Nutrition: Less Than Body Requirements as appropriate for a client with osteoporosis. Which client statement indicated to the nurse that this nursing diagnosis was appropriate?
A) "I like to remove all of the fat from the meat I eat."
B) "I am trying to eat a low-carb diet."
C) "I plan to start eating out less."
D) "I am allergic to dairy products."
D
A client who is at risk for developing osteoporosis asks what can be done to decrease the risk of actually developing the disease. Which intervention would be the most beneficial for this client?
A) Decreasing the amount of calcium in the client's diet
B) Providing the client with assisted range of motion exercising twice daily
C) Increasing regular weight-bearing activities
D) Protecting the client's bones with strict bedrest
C
An adult client who resides in a long-term care facility is diagnosed with osteoporosis. The client has a history of falls and dementia. Which nursing intervention will best aid in meeting an outcome goal of injury prevention for this client?
A) Using furniture as obstacles to keep the client in the bed
B) Keeping the bed in the lowest position
C) Keeping a nightlight on in the hallway
D) The use of wrist restraints
B
The nurse is providing teaching to a young adult who is at risk for early-onset osteoporosis. Which intervention should the nurse suggest?
A) The client should stop all physical activity.
B) The client should reduce the intake of dairy in the diet.
C) The client should increase intake of calcium and vitamin D.
D) The client should start estrogen replacement therapy.
C
A postmenopausal adult client is concerned about the development of osteoporosis and wants to begin preventative activities. Which statement by the nurse is appropriate?
A) "You should first determine if you are at risk for the development of osteoporosis."
B) "After menopause, the decline is too rapid to begin preventative interventions."
C) "Weight-bearing exercise and calcium supplements are helpful in the prevention of osteoporosis."
D) "Hormone replacement therapy should be initiated as soon as possible."
C
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.
A) "The most common adverse effect is hypercalcemia caused by taking too much of the supplement."
B) "Oral calcium supplements are best taken on an empty stomach."
C) "Adults 50 years of age and over should obtain at least 500 to 750 mg per day of elemental calcium."
D) "If you have a condition called ventricular fibrillation, this medication might help."
E) "Report symptoms of weakness, increased urination, and thirst."
A,E
A nurse is educating a group of adults about the risks for osteoporosis. Which statements will the nurse include when discussing the use of alcohol and cigarettes? Select all that apply.
A) "Smoking decreases nerve supply to the bones."
B) "Nicotine increases calcium absorption, leading to decreased bone density."
C) "Moderate alcohol consumption in postmenopausal women actually may increase bone mineral content."
D) "Alcohol has a direct toxic effect on osteoclast activity, suppressing bone formation."
E) "Heavy alcohol use may be associated with nutritional deficiencies that contribute to osteoporosis."
C,E
Which change in bone structure contributes to osteoporosis?
A) The diaphysis of the bone becomes longer.
B) Trabeculae are increased in cancellous bone.
C) The outer cortex of the bone becomes thicker.
D) The diameter of the bone increases.
D
What is the primary cause of loss of height in individuals with osteoporosis?
A) Collapse of vertebral bodies
B) Decrease in length of long bones
C) Flexion of the knees and hips
D) Cervical lordosis
A
The nurse is caring for an 8-year-old client with cerebral palsy and limited walking ability. The parents are very protective and perform most activities for the child. Which intervention is essential in promoting bone growth and reducing the risk of osteoporosis?
A) Provide client teaching related to using restraints to prevent falls.
B) Provide client teaching related to assistive devices to encourage walking.
C) Refer the client to a dietitian to increase calcium and vitamin D intake.
D) Refer the client to an occupational therapist to increase limb movement.
B
The nurse is caring for a woman who is at 14 weeks' gestation with her first child. The woman asks the nurse, "Am I at risk for osteoporosis since my baby takes calcium from my body?" What response by the nurse is correct?
A) "You may lose small amounts of bone mass with each pregnancy, but if you only have one child, the bone loss should not be significant enough to cause osteoporosis."
B) "When bone mass is lost during pregnancy, it is very difficult to restore, and you may be at increased risk for osteoporosis later in life. You should take a calcium supplement to prevent this."
C) "If you eat a diet that is rich in calcium, any bone mass that is lost during pregnancy and breastfeeding will be restored within several months of weaning the child."
D) "The baby won't require enough calcium during development to affect your bone mass or cause osteoporosis."
C
Which of the following is the major mechanism for maintaining bone density in the body? Select all that apply.
1.Appropriate body alignment
2.Avoiding prolonged use of antacids
3.Greater osteoblast formation and limited osteoclast formation
4.Active and passive exercises
5.High protein diet
2,3
67-year-old client asks the nurse about osteoporosis. The nurse responds that osteoporosis is defined and characterized as:
1.thickening of the outer cortex of the bones.
2.new, but weaker, bone growth.
3.loss of bone mass or density.
4.having only unmodifiable risk factors.
3
A client attending a community information session on health topics and the elderly notes that her nurse practitioner recently placed her on Fosamax and asks for more of an explanation about what this drug does. The nurse would advise her that Fosamax (or alendronate) is used for what purpose?
1.Decreasing spinal fractures and preventing formation of thrombosis
2.Inhibiting osteoclastic activity, which causes bone resorption and decreasing the incidence of vertebral and other fractures
3.Suppressing inflammation and the normal immune response and enhancing metabolic processes
4.Binding bile acids in the gastrointestinal tract to enhance calcium resorption
2
Which nursing intervention(s) is/are important when alendronate (Fosamax) is prescribed for an older client? (Select all that apply.)
1.Instruct the client to take Fosamax on an empty stomach, first thing in the morning and with water.
2.Instruct the client to take the medication with meals, highly fluid soups, or cereals.
3.Instruct the client to remain upright for 30 minutes and to not eat or drink anything else for 30 minutes.
4.Monitor daily weight and observe for signs of weight gain.
5.Avoid taking Fosamax if the client has a history of blood clots.
1,3,5
Although all of the following nursing diagnoses are important when planning care for the client with osteoporosis, which will the nurse select as the most significant in terms of long-term disability?
1.Risk for falls
2.Chronic pain
3.Acute pain
4.Activity intolerance
1
When teaching the client with osteoporosis about preventive measures to avoid complications of osteoporosis, the nurse would emphasize which topic?
1.Blood clots'
2.Contractures
3.Infection
4.Fractures
4
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