Osteoporosis: Causes, Risk Factor, Symptoms, and Treatment
Introduction:-
- Abnormal rarefaction of bone which may be idiopathic or secondary to other conditions.
- This disorder leads to the thinning of skeletal and decreases precipitation of lime salt.
Osteoporosis Definition:-
- Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and micro-architectural determination of bone tissue that leads to increase bone fragility and susceptibility to fracture or breakdown (hips, vertebrae, forearm).
Osteoporosis Etiology or Osteoporosis causes:-
- Increase aged
- Poor diet(low calcium and vitamin D)
- chronic alcoholism
- Tobacco, smoking
- Lack of exposure to sunlight
- lack of physical exercise
- Hyperthyroidism
- Estrogen deficiency after menopause
- surgical removal of ovaries
- Excessive secretion of parathyroid hormone
- Certain medication (chemotherapy, Anti-seizure)
- Family history of genetic
- Excessive consumption of soft drinks(increase amount of phosphoric acid)
Osteoporosis Pathophysiology:-
- Due to any etiological factor
- calcium resorption
- increase in osteoclast activity
- Brittle or fragile bones
- Reduction in resistance of bone towards physical stress
- Fracture ,improper gait and reduction in height
- Bone is dynamic tissue that undergoes that continue remodeling (the process by which old bone is replaced by new bone)
- the remolding sequence start with activation of osteoclast which resorb a small portion of bone over a relatively short period of time (7-10 days)bone formation then take place as osteoblast form an organic matrix that is subsequently mineralized.
Clinical Manifestation or Osteoporosis Sign and Symptoms:-
- Sudden onset of severe back pain .
- Kyphosis (posterior curvature of spine or humpback)
- Abdominal distention
- Impaired respiration due to restricted lung expansion
- Loss of denture or teeth (due to loss in mandible) and finally fracture specially hip,vertebrae,forearm
- Improper gait, and reduction in height
Osteoporosis Investigation:-
- Physical examination
- Family history
- dual-energy X-ray
- Blood test
- Urine calcium level
- CT,MRI
Management of Osteoporosis:-
Medial management of osteoporosis :-
- Bisphosphonate
- Estrogen therapy (in early menopause)
Nursing management of osteoporosis:-
- Pain related to fracture
- Altered nutrition less then body requirement related to calcium and vitamin D deficiency
- Risk of fracture due to disease condition softening of bone
- Impaired physical activity due to disease condition.
Nursing Responsibility:-
- Adequate intake of calcium and vitamin D
- Regular weight bearing exercise
- Avoidance of alcohol and tobacco
- Assess clients at risk of fracture for activity level and dietary adequacy and programme appropriate teaching to prevent fracture
- Assessment include visual assessment medication that may cause dizziness or postural HTN.
- Difficulties with balance or co-ordination as well as the home environment for potential safety from hazards.
- Evaluation of the bone setting is performed via admission assessment discussion with the client consultation with specialist in social service and home safety evaluation by visiting nursing.
- Instruct the client who are prompt to dizziness to get up slowly from a lying position sitting on the site of the bed first.
- An aid to ambulation such as a cane or walker may also indicated to prevent falling.
- Handrails should be also available or provided especially in the bathroom or toilets.
