Osteoporosis is a metabolic bone disorder characterized by decreased bone mass and density, leading to porous and brittle bones that are prone to fracture. It is classified as either primary or secondary osteoporosis. Primary osteoporosis includes type I, which usually affects postmenopausal women, and type II, which occurs most commonly in those ages 70-85. Symptoms may include fractures after minor trauma. Diagnosis involves imaging tests to measure bone mineral density. Treatment focuses on controlling bone loss and preventing fractures through exercise, medication, supplements, and lifestyle changes. Nursing care emphasizes safety, mobility, nutrition, pain management, and education.

1. OSTEOPOROSIS

2. OVERVIEW

5. OsteoporosisMetabolic bone disorderThe result is decreased bone mass Bones become porous, brittle, and abnormally vulnerable to fracture

6. Primary

7. Secondary to an underlying disease

8. Classification of Primary OsteoporosisIdiopathic osteoporosis affects children and adultsType I (or postmenopausal) osteoporosis Usually affects females ages 51 to 75

9. Related to the loss of estrogen's protective effect on bone

10. Results in trabecular bone loss and some cortical bone loss

11. Vertebral and wrist fractures are common. Type II (or senile) osteoporosis occurs most commonly between ages 70 and 85

12. Trabecular and cortical bone loss

13. fractures of the proximal humerus, proximal tibia, femoral neck, and pelvis

14. Pathophysiology and etiology

17. The rate of bone resorption increases over the rate of bone formationloss of bone massCalcium and phosphate salts are lostporous, brittle bonesOccurs most commonly in postmenopausal women

19. COmplications

20. FracturesMost common: vertebrae, femoral neck, distal radiusProgressive kyphosisloss of height Chronic back pain from compression fracture

21. Typical loss of height associated with osteoporosis and aging

22. Clinical manifestations

23. Asymptomatic until later stagesFracture after minor trauma may be first indicationMost frequent fractures associated with osteoporosis include fractures of:distal radiusvertebral bodiesproximal humerusPelvisproximal femur (hip)

24. May have vague complaints related to aging processStiffness

25. Pain

26. WeaknessEstrogen deficiency may be noted

27. Diagnostic evaluation

28. Differential diagnosisexclude other causes of rarefying bone disease, especially those that affect the spine

29. metastatic carcinoma, advanced multiple myelomaX-rays show changes only after 30% to 60% loss of boneDEXADual-energy X-ray absorptiometry

30. Shows decreased bone mineral density

31. T score -2.5 or worse

32. Serum and urine calcium levelsnormalSerum bone GLA-proteinMarker for bone turnover

33. ElevatedBone biopsy Shows thin, porous, otherwise normal boneSpine Computed Tomography Scan Shows demineralization

34. Quantitative computed tomography can evaluate bone density

35. Less available and more expensive than DEXAMANAGEMENT

36. GOAL:To control bone loss

37. prevent additional fractures

38. control pain

39. Treatment:

40. physical therapy program of gentle exercise and activity

41. drug therapy to slow disease progress

42. supportive devices

43. surgeryMedications

44. BiphosphonatesAlendronate, Risedronate

45. To prevent bone loss and reduce the risk of fracturesCalcium and vitamin D supplements To support normal bone metabolism

46. Raloxifene and calcitonin

47. To reduce bone resorption

48. To slow the decline in bone mass

49. Supportive devices and surgery

50. Back braceSupports weakened vertebraeSurgery open reduction and internal fixation

51. to correct pathologic fractures of the femur

52. Reduction and Immobilization

53. with a cast

54. Required in Colles' fracture

55. 4 to 10 weeksLifestyle modification

56. DietAdequate intake of dietary calcium

57. Decreased alcohol consumption and caffeine useRegular ExerciseSmoking cessation

58. Hormonal and fluoride treatment