Osteoporosis by Kerstin Karen Vicente, RN

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"POROUS BONES“ from Greek: οστούν/ostoun meaning "bone" and πόρος/poros meaning "pore" KERSTIN KAREN VICENTE, RN

description

Osteoporosis

Transcript of Osteoporosis by Kerstin Karen Vicente, RN

Page 1: Osteoporosis by Kerstin Karen Vicente, RN

"POROUS BONES“from Greek: οστούν/ostoun meaning

"bone" and πόρος/poros meaning "pore"

KERSTIN KAREN VICENTE, RN

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A condition of skeletal fragility characterized by compromised bone strength predisposing to an increased risk of fracture

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ASSESSMENT

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Age/Gender

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Race

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Lifestyle/Diet

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Personal/family history of fractures

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Height

Spinal curves

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DIAGNOSTICS

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Dual-Energy X-Ray Absorptiometry (DEXA)

Measures bone mineral density which can be determined from the absorption of each beam by bone

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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.

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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.

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INCIDENCE

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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.

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Incidence

The National Osteoporosis Foundation (2006)

10M people have osteoporosis34M have low bone mass80% are women

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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.

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Incidence

1:2 women1:4 men

Over age 50 will have an osteoporosis related fracture

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PATHOPHYSIOLOGY

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Male Female

↓Testosterone

Menopause

↓ Estrogen

↓Ca absorption

↓Thyroid stim↓Calcitonin

↑Osteoclast

↓Osteoblast

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Race

↓Pigmentation

↓Bone mass

Europeans

Americans

Asians

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Endocrine Disorders

Hyperthyroidism

Hyperparathy

Cushing’s DM

↓Bone minerals

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Age

↓BMD

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Smoking

Vasoconstriction Impaired cell absorption

↓Blood supply

↓Osteoblast

↓Bone density

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Lifestyle

Female athletes

Eating disorder

s

Amenorrhea

↓Estrogen Nutritional deficiency

Sedentary

Minimal blood flow to bones

↓Nutrients

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Alcohol

Moderate

↑Estrogen&Calcium

↑Bone mineral content

Intoxication

Suppressed bone

formation

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Diet

Removal of ca from skeleton

↑ Phosphate

↑ Protein↓ Ca

Weakened bone tissue

Acidosis

Attempts to buffer

excess acid

Osteoclast formation

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Medication

Corticosteroids Heparin

Affects calcium & sex

hormones

Aluminum containing antacids,

Anti-convulsants

↑ Resorption

↑Ca excretionBone

density loss

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↑BONE RESORPTION

↓BONE FORMATION

Susceptible to fractures

Thinner outer supporting

cortex

Diameter of bone enlarges

Wedging & collapse of vertebrae

Kyphosis↓Height

Dowager’s hump

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TYPE I

Post menopausalSenile

PRIMARY

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TYPE II

DrugsDiseases

SECONDARY

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NURSING DX

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Acute painrelated to compression of vertebral spine secondary to osteoporosis

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Imbalanced nutrition: less than body requirements related to inadequate calcium intake

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Risk for injury related to bone fragilitysecondary to osteoporosis

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