OSTEOPOROSIS.pptx Dr Hadi AlHamzi amran university

OSTEOPOROSIS.pptx Dr Hadi AlHamzi amran university

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  OSTEOPOROSIS Prepared by: Dr. HadiAl-Hamzi MBBS, MCM Faculty of Medicine Department of community Amran University
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  OUTLINE • Definition. • Pathophysiology. •Risk factor. • Causes. • Signs and symptoms. • Diagnostic procedure. • Prevention and medical management. • Nursing process
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  Definition  Metabolic skeletaldisease characterized by  low bone density and microarchitectural deterioration of bone tissue, which results in  increased bone fragility and susceptibility to fracture.  The vertebrae ,wrists ,and hips are the most common sites of fractures
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  Pathophysiology • Result ofprolonged imbalance of Bone Remodeling; - Bone remodeling occurs throughout an individual’s lifetime. - In normal adults, the activity of osteoclasts (bone resorption) is balanced by that of osteoblasts (bone formation). - Normal bone remodeling in the adult result in gradually increase bone mass until the early 30s. * With ageing the peak bone mass is gradually decrease and 1.Calicitonin: inhibit bone resorption & promote B. formation. (Decrease) 2. Estrogen: inhibit bone breakdown. (Decrease) 3. PTH increase bone turnover and resorption. (Increase)
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  - Female morethan male. - Caucasian, asian - Increase age. - Estrogen deficiency or menopause. - Inadequate intake of calcium and vit D. - Lack of physical activity . - Smoking , alcohol consumption - Medication. (corticosteroids, antiseizure ) - Low weight and body mass index. Risk Factors
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  Causes of Osteoporosis: (A)Idiopathic age related osteoporosis (most common): (1) Young adults. (2) Postmenopausal (type I) (3) Senile (type II) (B) Osteoporosis secondary to disease states: 1. Metabolic conditions e.g calc. deficiency, vit. D deficiency, malnutrition, Scurvy. 2. Endocrine conditions e.g, Hyperparathyroidism. 3. Renal disease. 4. Gastrointestinal - Liver disease. 5. Bone marrow infiltration e.g, Leukemia. 6. Drugs e.g Phenobarbital, Thyroid hormones, Corticosteroid. 7. Life style e.g Nutnition, alcohol, smoking, inactivity, immobilization, excessive caffeine 8. Miscellaneous e.g Rh. arthritis .
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  Signs and symptoms •Osteoporosishas been called “silent disease” because bone mass is lost over many years with no sings or symptoms. CM: 1. Loss of height. 2. Back pain. 3. Vertebrae collapse (dowager’s hump)
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  Diagnosing Osteoporosis 1. X-ray studies: determine bone density. 2. Radiographic: bone mass (osteopenia). 3. Ultrasonography: determine bone density. 4. Dual -Energy X -ray Absorptiometry (DEXA) is the preferred modality for measuring bone mineral density (BMD).
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  Prevention and medicalmanagement • The main goal of treatment is to prevent development of osteoporosis and to stabilize remaining bone mass. (1) Calcium rich diet especially in childhood. • Adolescents may need 1200 mg and postmenopausal women may need 1500 mg daily. • Milk, cheese and yogurt are rich in calcium. • Elderly should be advised to take 400 - 800 units of Vit. D daily Comes (from 2 sources : the sun and Fortified dairy products, egg yolks, saltwater fish, and liver)
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  Prevention and medicalmanagement (2) Never Smoking. (3) Exercise. • Exercising regularly in childhood and adolescence can ensure that you will reach peak bone density. (4) Alcohol , caffeine intake should be avoided. (5) Women with low body w.t (those with eating disorders) should receive appropriate evaluation, Rx and dietary counseling
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  Intervention • Consumes adequatedietary calcium and vit D. • Encourage to increase level of exercise. • Modify lifestyle choices: Avoid smoking, alcohol, carbonated beverages. • Maintain optimal body wt. • Creates safe home environment. • Adheres to prescribe screening and monitoring procedures. • Take prescribed medication as instruction
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  Reference: • Brunner &suddarth’s Textbook of medical- surgical nursing.11th edition. • Web site: -www.nursing4all.com -www.nursingcaste.com
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