osteoporosis by kerstin karen vicente, rn
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“
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"POROUS BONES“from Greek: οστούν/ostoun meaning
"bone" and πόρος/poros meaning "pore"
KERSTIN KAREN VICENTE, RN
A condition of skeletal fragility characterized by compromised bone strength predisposing to an increased risk of fracture
ASSESSMENT
Age/Gender
Race
Lifestyle/Diet
Personal/family history of fractures
Height
Spinal curves
DIAGNOSTICS
Dual-Energy X-Ray Absorptiometry (DEXA)
Measures bone mineral density which can be determined from the absorption of each beam by bone
Ultrasound
Transmits painless sound waves through the heel of the foot to measure bone density. Heel bone - a weight bearing bone with a high incidence of trabecular bone and is on the
same axis as the hip joint.
Alkaline phosphatase (AST)
Elevates following a fracture, and serum bone Glaprotein (osteocalcin), marks of osteoclastic activity.
This test is most useful to evaluate the effects of treatment, rather than as indicator of the severity of the disease.
INCIDENCE
Incidence
Awareness of osteoporosis in the Philippines was one of the lowest when compared to other Asian countries in the mid 1990s.
Ten years later, awareness of the disease has moved one level higher.
Incidence
The National Osteoporosis Foundation (2006)
10M people have osteoporosis34M have low bone mass80% are women
Phil.Population: 96M. Over 60 yo: 6.0 to 6.7% (6M) of population
It is expected to increase to 110 million by 2020 and 146 million by 2050.
Incidence
1:2 women1:4 men
Over age 50 will have an osteoporosis related fracture
PATHOPHYSIOLOGY
Male Female
↓Testosterone
Menopause
↓ Estrogen
↓Ca absorption
↓Thyroid stim↓Calcitonin
↑Osteoclast
↓Osteoblast
↓
Race
↓Pigmentation
↓Bone mass
Europeans
Americans
Asians
Endocrine Disorders
Hyperthyroidism
Hyperparathy
Cushing’s DM
↓Bone minerals
Age
↓BMD
Smoking
Vasoconstriction Impaired cell absorption
↓Blood supply
↓Osteoblast
↓Bone density
Lifestyle
Female athletes
Eating disorder
s
Amenorrhea
↓Estrogen Nutritional deficiency
Sedentary
Minimal blood flow to bones
↓Nutrients
Alcohol
Moderate
↑Estrogen&Calcium
↑Bone mineral content
Intoxication
Suppressed bone
formation
Diet
Removal of ca from skeleton
↑ Phosphate
↑ Protein↓ Ca
Weakened bone tissue
Acidosis
Attempts to buffer
excess acid
Osteoclast formation
Medication
Corticosteroids Heparin
Affects calcium & sex
hormones
Aluminum containing antacids,
Anti-convulsants
↑ Resorption
↑Ca excretionBone
density loss
↑BONE RESORPTION
↓BONE FORMATION
Susceptible to fractures
Thinner outer supporting
cortex
Diameter of bone enlarges
Wedging & collapse of vertebrae
Kyphosis↓Height
Dowager’s hump
TYPE I
Post menopausalSenile
PRIMARY
TYPE II
DrugsDiseases
SECONDARY
NURSING DX
Acute painrelated to compression of vertebral spine secondary to osteoporosis
Imbalanced nutrition: less than body requirements related to inadequate calcium intake
Risk for injury related to bone fragilitysecondary to osteoporosis
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