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Osteo Ma Laci A Osteoporosis
Osteo Ma Laci A Osteoporosis
Osteoporosis
Characterized by low bone mass and structural deterioration
Osteoporosis
Chronic, progressive metabolic bone
disease characterized by
Porous bone
___ ____ ____
Structural deterioration of bone tissue
Increased bone fragility
Osteoporosis
Eight times more common in women than
men for several reasons
1. Lower calcium intake than men
2. Less bone mass because of smaller frame
3. Bone resorption begins earlier and
accelerates after menopause
4. Pregnancy and breastfeeding deplete
womans skeletal reserve of calcium
5. Longevity increases likelihood of
osteoporosis; women live longer than men
Etiology
Risk factors (non-modifiable)
Female gender
Increasing age
Family history
White or Asian ethnicity
Small stature
Early menopause
Etiology
Risk factors (contd)
Excess alcohol intake
Cigarette smoking
Anorexia
Oophorectomy
Sedentary lifestyle
Insufficient calcium intake
Low testosterone levels (hypogonadism
in men)
Osteoporosis
Diagnostic Studies
Clinical Manifestations
Known as silent disease
Diagnosis
Bone Mineral Density (BMD)
Dual-energy x-ray absorptiometry (DEXA)
History and physical
Quantitative ultrasound
Osteoporosis
Calcium
There are a variety of calcium supplements
available (See Table 64-16, p. 1689).
They should be taken with _______ _ to aid in
absorption.
Also if taking large doses i.e. 1000 mg. / day take
in divided doses of 500mg BID for better absorption
Osteomalacia
Metabolic Bone Disease
Osteomalacia
Decalcification and softening of the bone
Caused mainly by: vitamin D deficiency
**Vitamin D is required for the absorption of
calcium from the intestine and calcium is
responsible for mineralization of bone
Etiology
Lack of exposure to __________ ____
GI malabsorption, extensive burns, chronic diarrhea,
pregnancy, drugs such as Dilantin.
Osteomalacia
Signs & Symptoms
Most Common
____ ____
Difficulty rising from a chair
Difficulty walking
Additional Signs and Symptoms
Low back pain, muscle weakness
Weight loss, progressive deformities
Diagnosis
Blood work
Decreased serum calcium or phosphorus
Decreased serum 25-hydroxyvitamin D
Elevated alkaline phosphatase
X-Rays
Show loosers transformation zone
ribbons of decalcification in bone
Osteomalacia
Treatment and Nursing Care
Drug Therapy
Diet Therapy
Milk, yogurt, cheese
Dark green leafy vegetables, okra, broccoli
Fish and seafood
Almonds
Pagets Disease
Pagets Disease
Excessive bone resorption followed by
replacement of normal marrow by
vascular, fibrous connective tissue.
The new bone is ______, ____________,
___ ______
Most often affect the pelvis,
long bones, spine,
ribs, sternum, and cranium
Clinical Manifestations
In milder form, none
Common early symptom-Fatigue
Waddling gait
Loss of height
Increased head size
Complications
Pathological fractures (may be a first
sign of disease)
Bone tumors
Pagets Disease
Diagnosis
Elevated serum alkaline phosphatase
X-ray will show increase in bone size
Bone scan shows increased uptake in
affected bones
Pagets Disease
Other treatments and Nursing Care
Back support by firm mattress
Teaching about use of splints or braces to
support bones and joints and help prevent
weakened bones - skin care, circulation,
etc.
Teach how to correctly use canes or
walkers
Physical therapy
Diet high inwhat?