(^276) Medical-Surgical Nursing Demystified
- Loss of height
- Excessive forward curvature of the thoracic spine (kyphosis) due to patho-
logic vertebral fractures; collapsing of the anterior portion of the vertebral
bodies in the thoracic area - Fracture with minor trauma
INTERPRETING TEST RESULTS
- X-ray shows demineralization of the bone—not an early sign.
- Dual energy x-ray absorptiometry (DEXA) shows decrease in bone mineral
density in the hip and spine compared to young normal patients, and com-
pared to age-matched, race-matched, sex-matched patients.
TREATMENT
It is much more cost-effective to focus on prevention of osteoporosis. Encourage
adequate exercise and nutrition. Calcium supplementation may be necessary for
patients who are not getting the recommended daily requirement of calcium in the
diet. The body stores calcium in the bones. If there is insufficient dietary intake,
the body will remove the calcium from the bone, further weakening the structural
integrity. Once osteoporosis occurs, proper medical management is important to
prevent fractures and increase bone density.- Administer bisphosphonate drugs to inhibit osteoclastic bone resorption and
increase bone density:- alendronate, risedronate, ibandronate sodium orally
- parenteral preparations zoledronic acid, pamidronate
- Administer calcitonin nasal spray to increase bone density, also has analgesic
effect on bone pain after 2 to 4 weeks. - Administer selective estrogen receptor modulator for postmenopausal women
for prevention of osteoporosis:- raloxifene
- Administer teriparatide to stimulate the production of collagenous bone to
increase bone density. - Administer vitamin D, which enhances the absorption of calcium; many
patients with osteoporosis are also deficient in vitamin D.