Presentation on osteoporesis
OSTEOPOROSIS
DEFINITION
• Metabolic skeletal disease characterized by low bone density and
microarchitectural deterioration of bone tissue which results in increased
bone fragility and susceptibility to fracture.
• The vertebrae ,wrists ,and hips are the most common sites of fractures.
PATHOPHYSIOLOGY
PATHOPHYSIOLOGY
•Result of prolonged imbalance of Bone Remodeling; - Bone remodeling
occurs throughout an individual’s lifetime. - In normal adults, the activity
of osteoclasts (bone resorption) is balanced by that of osteoblasts (bone
formation). - normal bone remodeling in the adult result in gradually
increase bone mass until the early 30s. * with ageing the peak bone mass
is gradually decrease and
1. Calicitonin which inhibit bone resorption and promote bone formation.
(decrease)
2. Estrogen which inhibit bone breakdown. (decrease)
3. PTH increase bone turnover and resorption. (increase)
RISK FACTORS
RISK FACTORS
-female more than male.
-increase age.
-inadequate intake of calcium and vit D.
-estrogen deficiency or menopause.
-family history.
- Lack of physical activity .
-Smoking , alcohol consumbtion
-medication. (corticosteroids, antiseizure )
- low weight and body mass index.
-caucasian, asian.
CAUSES OF OSTEOPOROSIS
CAUSES OF OSTEOPOROSIS:
• Idiopathic age-related osteoporosis (most common):
• (1) Young adults
• (2) Postmenopausal (type I)
• (3) Senile (type II).
(B) OSTEOPOROSIS SECONDARY TO DISEASE
STATES
(B) OSTEOPOROSIS SECONDARY TO DISEASE STATES:
• Metabolic conditions e.g calc. deficiency, vit. D deficiency, malnutrition,
scurvy.
• Endocrine conditions e.g, Hyperparathyroidism.
• Renal disease.
• Gastrointestinal-liver disease.
• Bone marrow infiltration e.g, leukemia.
• Drugs e.g Phenobarbital, Thyroid hormones, Corticosteroid.
• Life style e.g Nutnition, alcohol, smoking, inactivity, immobilization,
excessive caffeine
• Miscellaneous e.g Rh. arthritis ..
SIGNS AND SYMPTOMS
Signs and symptoms
• Osteoporosis has been called “silent disease” because bone mass is lost
over many years with no sings or symptoms.
•CM:
1.Loss of height.
2.Back pain.
3. vertebrae collapse. (dowager’s hump)
DIAGNOSIS EVALUATION
Diagnosing Osteoporosis
1.x-ray studies: determine bone density.
2. radiographic: bone mass. (osteopenia).
3.ultrasonography:determine bone density.
4. Dual-energy x-ray absorptiometry (DEXA) is the preferred modality for
measuring bone mineral density (BMD).
PREVENTION AND MEDICAL MANAGEMENT
• The main goal of treatment is to prevent development of osteoporosis and
to stabilize remaining bone mass.
(1) A calc. rich diet esp. in childhood.
• adolescents may need 1200mg and postmenopausal women may need
1500mg daily.
• Milk, cheese and yogurt are rich in calcium.
• Elderly should be advised to take 400-800 units of Vit. D daily Comes (from
2 sources : the sun and Fortified dairy products, egg yolks, saltwater fish,
and liver)
(2) Never Smoking.
DRUG THERAPY
DRUG THERAPY
1.calcitonin: a synthetic thyroid hormone usually prescribe as a daily nasal
spray to reduce factors that cause loss of calcium and increase
reabsorption of calcium in the gastrointestinal tract.
2. Selective Estrogen Receptor Modulators.
3. Hormone Replacement Therapy: to increase serum estrogen levels, which
in turn decrease the rate of bone resorption.
Nursing process assessment
• Profile: Age & gender
• Risk factor
• Secondary causes
• Symptoms related
• Past medical Hx
• Family Hx
• Social Hx History:
Physical Examination
Physical Examination:
• General:
- decreasing height greater > 1.5inches
- dorsal kyphosis
- exaggerated cervical lordoisis
- - low body weight.
• Assessed for:
- localized pain
- muscle spasm
- neurologic deficit (risk of spinal cord compression)
- - loss of strength
- - range of motion in the affected area
• Fractures most commonly occur in the vertebral bodies, wrist, humerus, hip. rib and
pelvis (in that order).
NURSING DIAGNOSIS:
Nursing diagnosis:
• acute pain
• Impaired physical mobility
• self-care deficit (Dressing or grooming)
• Imbalanced nutrition: Less than body requirements
• Risk for impaired skin integrity
• Risk for injury
• Risk for constipation RT immobility
• Deficient knowledge about the osteoporosic process and treatment
regimen.
REFERENCE:
REFERENCE:
• Brunner & suddarth’s Textbook of medical- surgical nursing.11th edition.
• Web site: -www.nursing4all.com -www.nursingcaste.com
