A 60-year-old woman has just been diagnosed with osteoporosis. She does not understand how this could be possible, as she has always been a milk drinker.
1. As the nurse caring for her, explain the risk factors for developing osteoporosis.
2. Explore patient-care technologies and how you would use these in educating her on this new diagnosis.
3. Identify the type of pain this individual will most likely experience with a diagnosis of osteoporosis. Briefly include the pathophysiology in your rationale to this answer.
Students Response Below:
Peer Response 1:
Lauren Koscal posted
Osteoporosis is defined as low bone mass leading to increased fracture risk. It comprises a heterogeneous group of syndromes in which the bones mass per unit volume is decreased in otherwise normal bones, rendering them more fragile and increasing their risk of fractures (Paloucci et al., 2016) The hallmark of osteoporosis is a reduction in skeletal mass caused by an imbalance between bone resorption and bone formation (Bethel, 2019) Majority of osteoporosis cases are related to postmenopausal women. Bone loss related to declining estrogen levels increases fracture risk. Screening and diagnosis use a bone mineral density measurement. Dual energy X-ray absorptiometry is most widely used to measure bone mineral density. Osteoporosis is preventable and treatable. Adequate combines calcium and vitamin D intake, antiresorptive therapy or estrogen-receptor modulators, weight-bearing exercise to improve muscle-strengthening and agility, tobacco avoidance, moderate alcohol intake, and avoidance of trip or fall hazards are the best ways to prevent osteoporosis (Kling, et al., 2014)
Technology has become readily available such as the internet that offers reputable medical websites where patients can look up their diagnosis, prevention, treatment, and prognosis. Patients who are newly diagnosed can be given medication handouts from websites such as Micromedix for educational purposes.
The most common cause of osteoporosis pain is spinal compression fracture. This includes sudden, severe, back pain that gets worse with standing or walking. Other parts of the body usually affected are the proximal end of the femur, distal end of the radius, and proximal end of the humerus (Kling et al., 2014) Pain usually rises with age affecting 41% of persons aged 65-75 years of age, 48% 75-85 years of age and 55% persons aged > 85 years (Kling et al., 2016) Other pain includes muscle spasms due to nerves being pinches as one’s muscles tense to protect the joints (Osteoporosis Ca, 2019)
Bethel, M. (2019, November 12). Osteoporosis. Retrieved from https://emedicine.medscape.com/article/330598-overview
Kling, J. M., Clarke, B. L., & Sandhu, N. P. (2014). Osteoporosis prevention, screening, and treatment: a review. Journal of women’s health (2002), 23(7), 563–572. doi:10.1089/jwh.2013.4611
Osteoporosis Canada. (2019). Osteoporosis Pain. Retrieved from https://osteoporosis.ca/bone-health-osteoporosis/living-with-the-disease/pain/.
Paolucci, T., Saraceni, V. M., & Piccinini, G. (2016). Management of chronic pain in osteoporosis: challenges and solutions. Journal of pain research, 9, 177–186. doi:10.2147/JPR.S83574
Peer Response 2:
Karen Antonino posted
Osteoporosis is a disease where increased bone weakness increases the risk of broken bones. Common bones affected include vertebrae, forearm bones and hips. Alcoholism, anemia, anorexia, hyperthyroidism, kidney disease, and surgical removal of ovaries all put an individual at increased risk for osteoporosis (Babu, Priya, & Gayathri, 2019).
Patients should be educated to take appropriate preventative measures including adequate calcium and vitamin d intake, exercise, smoking cessation, and moderation of alcohol use. A bone density test can be done to measure bone loss, known as a DXA test (dual energy x-ray absorptiometry test). If the score is -2.5 or less, treatment is recommended. Currently, nanotechnology treatment is being developed with the hope to change the way osteoporosis is treated and maybe even prevent it altogether. The drug being developed works at the molecular level by reducing bone breakdown and promoting bone formation, where most osteoporosis drugs on the market now only focus on bone reabsorption (www.nof.org).
Chronic pain is a multidimensional experience with sensory, affective and cognitive aspects. In osteoporosis, chronic pain can have sensory characteristics such as changes in posture, fractures, and muscle atrophy, as well as properties of nociceptive and neuropathic pain (Paolucci, Saraceni, & Piccinini, 2016).
Paolucci, T., Saraceni, V., and Piccinini, G. (2016). Journal of Pain Research. 9, 177-186.
Babu, V., Priya, V., and Gayathri, R. (2019). Drug Intervention Today. 11(7), 1515-1518.
National Osteoporosis Foundation. www.nof.org