N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Always check patient’s height every visit and log inchart • Inquire about family history, medication use, lifestyle factors, and diet • Use pain scale and ask about location of pain • Review radiology and laboratory reports: o DEXA (dual energy x-ray absorptiometry) scan: This can scan the bone to detect subtle changes in bone loss o CT scan/x-rays: X-rays can show degenerative processes near the joint areas like the spine and hips o Bone density: This test can measure actual bone mass o Serum calcium, phosphorus, and magnesium: Low levels of these minerals contribute to bone loss o Parathyroid hormone: This hormone released from the parathyroid glands assists in regulating calcium levels in the body; certain patients may develop secondary osteoporosis due to dysfunction of the parathyroid glands; renal disease and thyroid disease Impaired mobility related to deformity, pain, and muscle spasms • Risk for injury related to brittle bones, secondary to bone loss and low calcium absorption • Risk for ineffective management of medications and treatment plan • Imbalanced nutrition due to less mineral intake than body requirements Nursing interventions for osteoporosis: • Stress the importance of proper calcium intake in diet • Give medications per MD order: o Calcium: First line supplement for mild bone loss. Usually given twice daily with vitamin D. Have patient take carbonate with food for better absorption. Citrate can be taken any time. o Vitamin D: Supplement that helps calcium absorption. o Estrogen replacement therapy: This decreases the rate of bone resorption and bone loss in the body. o Bisphosphonates: Fosamax, Boniva, Actonel, Didronel, Aredia, Bonefos, and Skelid are taken once monthly and inhibit bone resorption. Fosamax must be taken first thing in the morning on an empty stomach. This medication must be taken with a full cup of water; the patient may not lie back down or eat for 30 minutes after taking Fosamax. o Analgesics: Pain medications may be used for pain as needed per MD order. ©2017 Achieve Test Prep Page 123 of 204 Nursing assessment for osteoporosis: • Nursing diagnosis for osteoporosis: •

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