Osteoporosis by Kerstin Karen Vicente, RN

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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.
  • Osteoporosis by Kerstin Karen Vicente, RN

    1. 1. “ "POROUS BONES“ from Greek: οστούν/ostoun meaning "bone" and πόρος/poros meaning "pore" ” KERSTIN KAREN VICENTE, RN
    2. 2. A condition of skeletal fragility characterized by compromised bone strength predisposing to an increased risk of fracture
    3. 3. ASSESSMENT
    4. 4. Age/Gender
    5. 5. Race
    6. 6. Lifestyle/ Diet
    7. 7. Personal/ family history of fractures
    8. 8. Height Spinal curves
    9. 9. DIAGNOSTICS
    10. 10. Dual-Energy X-Ray Absorptiometry (DEXA) Measures bone mineral density which can be determined from the absorption of each beam by bone
    11. 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. 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. 13. INCIDENCE
    14. 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. 15. Incidence The National Osteoporosis Foundation (2006) 10M people have osteoporosis 34M have low bone mass 80% are women 
    16. 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. 17. Incidence 1:2 women 1:4 men Over age 50 will have an osteoporosis related fracture
    18. 18. PATHOPHYSIOLOGY
    19. 19. Male Female ↓Testosterone Menopause ↓ Estrogen ↓Thyroid stim ↓Calcitonin ↑Osteoclast ↓Ca absorption ↓Osteoblast
    20. 20. Race ↓Pigmentation ↓Bone mass ↓ Asians Europeans Americans
    21. 21. Endocrine Disorders Hyperthyroidism Hyperparathy Cushing’s ↓Bone minerals DM
    22. 22. Age ↓BMD
    23. 23. Smoking Vasoconstriction ↓Blood supply ↓Osteoblast Impaired cell absorption ↓Bone density
    24. 24. Lifestyle Female athletes Sedentary Eating disorders Amenorrhea Minimal blood flow to bones ↓Estrogen Nutritional deficiency ↓Nutrients
    25. 25. Alcohol Moderate Intoxication ↑Estrogen&Calcium Suppressed bone formation ↑Bone mineral content
    26. 26. Diet ↓ Ca ↑ Protein Removal of ca from skeleton Acidosis Weakened bone tissue Attempts to buffer excess acid ↑ Phosphate Osteoclast formation
    27. 27. Medication Corticosteroids Affects calcium & sex hormones Bone density loss Aluminum containing antacids, Anticonvulsants ↑Ca excretion Heparin ↑ Resorption
    28. 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. 29. Post TYPE I PRIMARY menopausal Senile
    30. 30. TYPE II SECONDARY Drugs Diseases
    31. 31. NURSING DX
    32. 32. Acute pain related to compression of vertebral spine secondary to osteoporosis
    33. 33. Imbalanced nutrition: less than body requirements related to inadequate calcium intake
    34. 34. Risk for injury related to bone fragility secondary to osteoporosis

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