Osteoporosis

A disease of decreased bone density and increased fracture risk

Definition

Osteoporosis is a progressive skeletal disorder characterized by low bone density and microarchitectural deterioration, increasing bone fragility and fracture risk.

Risk Factors

  • Postmenopausal women (estrogen loss)
  • Advanced age
  • Caucasian or Asian ancestry
  • Family history
  • Low body weight
  • Smoking, alcohol use
  • Sedentary lifestyle
  • Low calcium/vitamin D intake
  • Chronic corticosteroid use
  • Thyroid disorders

Diagnosis

DEXA scan: T-score. Normal: greater than -1.0. Osteopenia: -1.0 to -2.5. Osteoporosis: less than -2.5.

Nursing Interventions

  • Calcium 1,200 mg and vitamin D 800 to 1,000 IU daily
  • Weight-bearing and resistance exercise
  • Fall prevention: remove rugs, improve lighting, assistive devices
  • Medications: bisphosphonates (alendronate, risedronate). Take with full glass of water, remain upright 30 minutes
  • Smoking cessation, limit alcohol
  • Avoid heavy lifting to prevent vertebral compression fractures

NCLEX Relevance

Bisphosphonate teaching: upright, empty stomach, water.