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METABOLIC DISORDERS OF THE BONE (Osteomalacia (Pathophysiology (deficiency…
METABOLIC DISORDERS OF THE BONE
Osteomalacia
Defination
a rare condition characterized by lack of normal calcium and phosphorus deposition in the matrix of the bone
Causes
lack of vitamin D
Nursing Management
vitamin D supplement are usually prescribed
dairy products with vitamin D
Pathophysiology
deficiency of vitamin D, which promote calcium absorption from gastrointestinal tract and facilitate mineralization of the bone
supply of calcium and phosphate in extracellular fluid is low
without adequate vitamin D, calcium and phosphate are not moved to calcification sites in bones
it may result in failed calcium resorption or from loss of calcium from the body
Medical Management
increases doses of vitamin D along with supplemental calcium are usually prescribed
exposure to sunlight for ultraviolet radiation to transform cholesterole substance to vitamin D is recommended
a diet with adequate protein and increased calcium and vitamin D
importance of monitoring serum calcium level is stressed as too much vitamin D can be toxic and enhance risk of hypercalcemia
Health Education
teach patient about the importance for a diet that is rich in vitamin D
focus on teaching the patient about the development of the disease
promote understand and treatment regime
Osteoporosis
Defination
a general reduction in skeletal bone mass and susceptibility of fracture
Causes
causes are unknown, but there are contributing factors such as long-term calcium deficiency
Nursing Management
give replacement of oestrogen in post menopausal women
give calcium supplements as prescribed
Pathophysiology
calcitonin, which inhibits bone resorption and promote bone formation is decreased
oestrogen which prevents bone breakdown decrease with age
parathyroid hormone increases with aging, increasing turnover and resorption. the consequences of these changes is net loss of bone mass over time
oestrogen withdrawal at menopause or oopherectomy causes an accelerated bone resorption that continues during menopausal years
Medical Management
balanced diet rich in calcium and vitamin D
to ensure adequate calcium intake, a calcium supplement may be prescribed and taken with beverages high in vitamin C to promote absorption
regular weight bearing exercise to promote bone formation
Health Education
encourage patient on regular weight bearing
emphasize the importance of having a diet rich in calcium and vitamin D
explain the precautionary measures to quit smoking and alcohol, that is if the patient is a user
Risk Factors
genetics, cigarette smoking
immobility
intake of caffeine and alcohol
Assessment and Common Findings
family history of pathological fracture
X-ray showing reduced density with wedging and collapse of vertebrae
early menopause and oestrogen deficiency
back pain, loss of weight and kyphosis