WELCOME

WELCOME

OSTEOPOROSIS

BY

Aseem.B, MBA, MSc N, PGDHA,Assistant Professor,

Department of Medical Surgical Nursing

SP Fort College of Nursing,Trivandrum.

DEFINITION OSTEOPOROSIS IS A DISEASE OF

BONES THAT LEADS TO AN INCREASED RISK OF FRACTURE.

OSTEOPOROSIS IS A CONDITION IN WHICH THERE WILL BE ABNORMAL RAREFACTION OF BONE WHICH MAY BE IDIOPATHIC OR SECONDARY TO OTHER CONDITIONS.

INCIDENCE

INCIDENCE

MOST COMMON IN WOMEN AFTER MENOPAUSE

WHO CONSIDERED IT AS A CHRONIC DISEASE

28 MILLION PEOPLE IN USA IS HAVING OSTEOPOROSIS.

INDIA ALSO SEVERAL MILLION PEOPLE ARE AFFECTED

RISK FACTORS

NON MODIFIABLE MODIFIABLE

GENETICS

GENETICS

SMALL FRAMED CAUCASIAN WOMEN ARE MORE RISK

FAMILY HISTORY HERITABILITY RANGING FROM 25 TO 80

% ASIAN WOMEN OF SLIGHTBUILD IS ALSO

HAVING RISK

AGE

AGE IN WOMEN AND MEN THERE IS

HORMONAL IMBALANCES AS AGE INCREASES

ESTROGEN LEVEL WILL BE ALTERED IN POSTMENOPAUSAL WOMEN

TESTOSTERONE LEVEL IS ALTERED IN OLD AGE.

VITAMIN D DEFICIENCY

EXCESS ALCOHOL

TOBACCO SMOKING

LOW WEIGHT/UNDERWEIGHT

HIGH PROTEIN DIET

LACK OF PHYSICAL EXERCISE

EXCESS PHYSICAL ACTIVITY

LACK OF EXPOSURE TO SUNLIGHT

HEAVY METALS EXPOSURE

SOFT DRINKS/ CAFFEINE

DISEASES / DISORDERS HYPOGONADAL STATES LIKE TURNER’S

SYNDROME,KLINEFELTER’S SYNDROME GASTOINTESTINAL DISEASES LIKE

CROHNS DISEASE, COELIAC DISEASE, SURGERY LIKE GASTRECTOMY, SEVERE LIVER DISEASES, RENAL

INSUFFICIENCY CAN LEAD TO OSTEO DYSTROPHY DUE TO EXCESSIVE CALCIUM DEPLETION

MEDICATION

CORTICOSTEROIDS ANTI SEIZURE DRUGS ANTI COAGULANTS PROTON PUMP INHIBITORS ANTI DIABETIC DRUGS

PATHOPHYSIOLOGY

SIGNS AND SYMPTOMS

FRACTURES

FRACTURES

TYPICAL LOSS OF HEIGHT

KYPHOSIS-DOWAGERS HUMP

KYPHOSIS-

CHRONIC PAIN

FALLS RISK

PULMONARY EMBOLISM

DIAGNOSIS

HEALTH HISTORY

PHYSICAL EXAMINATION

CONVENTIONAL RADIOGRAPHY

CT SCAN

DUAL ENERGY XRAY ABSORPTIONMETRY

T SCORE

QUALITATIVE ULTRA SOUND STUDIES

LABORATORY STUDIES

SERUM CALCIUM SERUM PHOSPHATE SERUM ALKALINEPHOSPHATASE URINE CALCIUM SEDIMENTATION HEMATOCRIT VALUES ERYTHROCYTE SEDIMENTATION RATE

MANAGEMENT

MEDICAL MANAGEMENT FRACTURE MANAGEMENT DIETARY MANAGEMENT NURSING MANAGEMENT

MEDICAL MANAGEMENT

MEDICAL MANAGEMENT HORMONE REPLACEMENT THERAPY -ESTROGEN -PROGESTERONE BISPHOSPHONATE THERAPY HELP BY INHIBITING THE

OSTEOCLAST FUNCTION - ALENDRONATE (FOSAMAX)

10MG/DAY - RISEDRONATE (ACTONEL) 5MG/DAY

MED MNGT CONTD SELECTIVE ESTROGEN RECEPTOR

MODULATORS -it act on the estrogen receptiors

through out the body in a selective manner.

-normally bmd is regulated by a balance between osteoblast and osteoclastactivity in the trabecular bone.

-Eg : Raloxifene ( it also reducethe risk of breast cancer.

CALCITONIN: PRIMARILY SUPRESSES BONE LOSS THROUGH DIRECT ACTION ON OSTEOCLASTS AND REDUCED BONE TURNOVER.ADMINISTERED THROUGH NASAL SPRAY/IM.

BONE ANABOLIC AGENTS INCLUDE TERIPARIDE, SODIUN FLUORIDE, CALCIUM SALTS

FRACTURE MANAGEMENT

FRACTURE MANAGEMENT

MANAGED SURGICALLY BY JOINT REPLACEMENT OR BY CLOSED OR OPEN REDUCTION WITH INTERNAL FIXATION.

Eg : HIP PINNING, SURGERY, INTENSIVE PHYSICAL THERAPY AND ADEQUATE NUTRITION

PINNING AND KYPHOPLASTY

KYPHOPLASTY

VERTEBRAL FRACTURES AND KYPHOSIS IS NOW PHARMACOLOGICALLY TREATED BY

PERCUTANEOUS VERTEBROPLASTY/KYPHOPLASTY

-( IN THIS AN INJECTION OF POLY METHYL METHACRYLATE BONE CEMENT INSTILLED IN TO THE FRACTURED VERTEBRA.

KYPHOSIS

KYPHOPLASTY

DIETARY MANAGEMENT

MILK AND MILK PRODUCTS

SUNLIGHT

NURSING MANAGEMENT

NURSING MANAGEMENT

HEALTH HISTORY : -IDENTIFICATION OF PEOPLE AT RISK FOR

OSTEOPOROSIS, -FOCUS ON FAMILY HISTORY, -RECOGNITION OF PROBLEMS

PHYSICAL EXAMINATION-DISCLOSE A FRACTURE-KYPHOSIS OR -SHORTENED STATURE

NURSING DIAGNOSIS ACUTE PAIN RELATED TO FRACTURE &

MUSCLE SPASM.

INEFFECTIVE COPING RELATED TO FEAR OF THE UNKNOWN, PERCEPTION OF THE DISEASE PROCESS.

DEFICIENT KNOWLEDGE ABOUT THE DISEASE PROCESS AND TREATMENT REGIMEN.

IMPAIRED PHYSICAL MOBILITY RELATED TO FRACTURED RIBS

NURSING DIAGNOSIS CONTD

RISK FOR CONSTIPATION RELATED TO IMMOBILITY OR DEVELOPMENT OF ILEUS.

RISK FOR INJURY : ADDITIONAL FRACTURES RELATED TO DISEASE PROCESS’

RISK FOR IMPAIRED THOUGHT PROCESS RELATED TO AGE ,STRESS, UNFAMILIAR SURROUNDINGS AND MEDICATION THERAPY.

NURSING INTERVENTIONS RELIEVING PAIN IPROVING BOWEL ELIMINATION PREVENTING INJURY PROMOTING UNDERSTANDING OF

OSTEOPOROSIS AND THE TREATMENT REGIMEN.

ENCOURAGE WALKING AND GOOD BODY MECHANICS.

MODIFICATION OF LIFE STYLE.

PREVENTION

LIFESTYLE MODIFICATION EXERCISES NUTRITION SUNLIGHT EXPOSURE

DO’S-

DON’T

NEW TECHNOLOGIES.HIP SAVERS…..

THANK YOU

THANK YOU