The nurse is working in a community clinic when a 62-year-old thin Asian female client comes in complaining of pain and swelling in the right forearm. She tells the nurse she tripped over her dog's leash and fell. A fracture of the right radius and ulna is confirmed, and the client is casted. Prior to discharge, the Care Provider asks the nurse to educate the client about osteoporosis.

1. Why would this client be at risk for osteoporosis? What are the risk factors?
2. What information would be included in that education?

 

Answer:

1. The reasons for risk of osteoporosis in the given client:

• The client in the given case has four risk factors namely elderly age (62 years), Asian ethnicity, female gender (menopause), thin body build which increases the risk for osteoporosis.

Risk factors for osteoporosis:

• Racial or ethnic factors such as White or Asian race
• Elderly age
• Female gender (especially after menopause)
• Thin body
• Family history of osteoporosis
• Obesity
• Endocrinal disorders such as Hypogonadism, Cushing syndrome, Hyperparathyroidism
• Lifestyle risk factors such as sedentary lifestyle, smoking, alcohol abuse
• Iatrogenic risk factors such as using corticosteroids, dilantin, loop diuretics
• Dietary factors such as low calcium intake, Vitamin D deficiency, malnutrition.
• Co-morbidities or other pathological conditions such as Guacher disease, Myeloma, Thalassemia, Renal insufficiency, Rheumatoid arthritis, Systemic lupus erythematosus.

2. Information to be included in patient education

Nurse should teach the following points in the patient education regarding osteoporosis:

• The patient should be advised to increase the dietary intake of calcium and vitamin D.
• Encouraging sun exposure to promote natural synthesis of vitamin D
• Encouraging ambulation to prevent further bone loss and immobility despite of the fracture as seen in the given case
• The patient should be advised to avoid alcohol consumption and smoking (if any)
• Caffeine consumption should be limited
• Teaching about regular weight bearing exercises, regular walking at least for a period of 30 minutes.
• Using supports and aids for proper gait and prevent stress on bones