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Osteoporosis (Risk Factors (Mild, prolonged negative calcium balance,…

- - - - Help patient identify situations and hazards that can cause accidents (increases awareness of potential dangers)
      - Assess the environment for risk to the patient, and alter as appropriate to prevent injury (minimizes risk of injury)
      - Maintain lighting so that patient can find way around room (poor lighting is a major cause for falls)
      - Place the call bell within reach and ensure the patient can use it. (ensures patient can call for help if necessary)
      - Assist with mobility getting out of bed, ambulation, as appropriate. (minimizes risk of injury)
    - - The patient will remain free from injury
  - - - The patient will have an adequate intake of calcium and Vitamin D throughout his stay
    - - Assess the patients dietary intake by asking him/her about eating habits (will help determine what foods to recommend to patient)
      - Provide patient with adequate diet (vitamin D, calcium, and protein will help provide appropriate nutrition that aid weakening bones)
      - Provide supplements of calcium and vitamin D as indicated ( help aid bone loss)
      - Teach patient foods rich in calcium and Vitamin D and the importance of consuming them, be exposed to sunlight. (Patient will learn what to eat to prevent bone loss)
      - Provide patient with handouts displaying foods rich in calcium and vitamin D ( will help patient remember patient teaching)
- - - - Control of bone loss
      - Prevention of additional fractures
      - Control of pain
      - Reduction and immobilization of fractures
      - Supportive devices
      - Physical and occupational therapy
      - Smoking cessation
      - Moderate exposure to sunlight
      - Identification and treatment of underlying conditions, such as hyperparathyroidism and hyperthyroidism
    - - Calcium-rich diet, including intake of 800 to 1,000 International Units of vitamin D daily (adults over age of 50)
      - Avoidance of excess phosphoric acid-containing beverages and excess protein intake
      - Avoidance of caffeinated products; alcohol intake in moderation
    - - Physical therapy program of gentle exercise and activity; postural retraining
      - Weight-bearing exercises (such as walking, jogging, stair climbing, and tai chi) 30 minutes three times weekly
      - Aerobic low-impact exercises (postmenopausal women)
      - Muscle-strengthening exercises
    - - Bisphosphonates, such as alendronate sodium (Fosamax), risedronate sodium (Actonel), ibandronate sodium (Boniva), and zoledronic acid (Reclast)
      - Calcitonin salmon
      - Raloxifene hydrochloride (Evista)
      - Monoclonal antibodies such as denosumab (Prolia)
      - Teriparatide (Forteo) (patients at high risk of fracture or who are unresponsive to bisphosphonate therapy)
      - Hormone replacement therapy (risks weighed against benefits)
      - Calcium and vitamin D supplements
    - - Open reduction and internal fixation for femur fractures
      - Percutaneous vertebroplasty (the surgical filling of an injured or collapsed vertebra. This procedure restores original shape and configuration and relieves pain from spinal compression)
      - Kyphoplasty (same procedure as above, only difference is that this one creates a cavity with a balloon inside the vertebrae first and uses minimal pressure to inject cement while the other uses high pressure)