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Osteoporosis by Kerstin Karen Vicente, RN
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Osteoporosis by Kerstin Karen Vicente, RN

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Osteoporosis

Osteoporosis

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  • he Cuba Clinical Ultrasound ScanIS AN ADVANCED BONE DENSITOMETRY INCORPORATING BUA and has been regarded as a major stride forward in the diagnosis and monitoring of osteoporosisCubaclinical draws on 11 years of technical development with clinical assessment trials and is the most sophisticated implementation yet of ultrasound technology.Cubaclinical uses a non-ionising, non-invasive approach to bone densitometry. Researches suggest that Broadband Ultrasonic Attenuation (BUA) gives not only information on bone density but also structure. This indicates that it may be a superior predictor of fracture risk than other forms of bone densitometry.The Cubaclinical machine beams ultrasound through the heel bone. The less sound that comes out of the heel bone, the denser the heel bone is. If the heel bone is good quality bone then it indicated that bones elsewhere in the body, for instance in the back and in the hip, are also of good quality. The heel bone has been selected as it is a weight bearing bone with a high incidence of trabecular bone and is on the same axis as the hip joint.
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    • 1. “ "POROUS BONES“ from Greek: οστούν/ostoun meaning "bone" and πόρος/poros meaning "pore" ” KERSTIN KAREN VICENTE, RN
    • 2. A condition of skeletal fragility characterized by compromised bone strength predisposing to an increased risk of fracture
    • 3. ASSESSMENT
    • 4. Age/Gender
    • 5. Race
    • 6. Lifestyle/ Diet
    • 7. Personal/ family history of fractures
    • 8. Height Spinal curves
    • 9. DIAGNOSTICS
    • 10. Dual-Energy X-Ray Absorptiometry (DEXA) Measures bone mineral density which can be determined from the absorption of each beam by bone
    • 11. 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.
    • 12. 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.
    • 13. INCIDENCE
    • 14. 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.
    • 15. Incidence The National Osteoporosis Foundation (2006) 10M people have osteoporosis 34M have low bone mass 80% are women 
    • 16. 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.
    • 17. Incidence 1:2 women 1:4 men Over age 50 will have an osteoporosis related fracture
    • 18. PATHOPHYSIOLOGY
    • 19. Male Female ↓Testosterone Menopause ↓ Estrogen ↓Thyroid stim ↓Calcitonin ↑Osteoclast ↓Ca absorption ↓Osteoblast
    • 20. Race ↓Pigmentation ↓Bone mass ↓ Asians Europeans Americans
    • 21. Endocrine Disorders Hyperthyroidism Hyperparathy Cushing’s ↓Bone minerals DM
    • 22. Age ↓BMD
    • 23. Smoking Vasoconstriction ↓Blood supply ↓Osteoblast Impaired cell absorption ↓Bone density
    • 24. Lifestyle Female athletes Sedentary Eating disorders Amenorrhea Minimal blood flow to bones ↓Estrogen Nutritional deficiency ↓Nutrients
    • 25. Alcohol Moderate Intoxication ↑Estrogen&Calcium Suppressed bone formation ↑Bone mineral content
    • 26. Diet ↓ Ca ↑ Protein Removal of ca from skeleton Acidosis Weakened bone tissue Attempts to buffer excess acid ↑ Phosphate Osteoclast formation
    • 27. Medication Corticosteroids Affects calcium & sex hormones Bone density loss Aluminum containing antacids, Anticonvulsants ↑Ca excretion Heparin ↑ Resorption
    • 28. ↑BONE RESORPTION ↓BONE FORMATION Diameter of bone enlarges Wedging & collapse of vertebrae Thinner outer supporting cortex ↓Height Susceptible to fractures Kyphosis Dowager’s hump
    • 29. Post TYPE I PRIMARY menopausal Senile
    • 30. TYPE II SECONDARY Drugs Diseases
    • 31. NURSING DX
    • 32. Acute pain related to compression of vertebral spine secondary to osteoporosis
    • 33. Imbalanced nutrition: less than body requirements related to inadequate calcium intake
    • 34. Risk for injury related to bone fragility secondary to osteoporosis

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