• Disease: Osteoporosis.

1. what is its Etiology?
2. pathophysiology?
3. Laboratory & Diagnostic tests?
4. Anticipated Ineffective Behaviors (clinical manifestations)?
5. Collaborative Interventions?

Medical: 1.

2.Nursing:

6. Top 3 (Actual or High Risk For)  Nursing Diagnoses:

1.The skeletal system is always being renewed - a new bone forms as an old one breaks down. New bones are created faster when an individual is still young, but it gradually slows down starting at the age of 20. Eventually, bone mass is lost rapidly than being made. The likelihood of developing osteoporosis depends on how much bone mass was is in one's bone bank - the higher it is, the less likely osteoporosis develops.

What puts an individual at high risk of developing osteoporosis?

• Sex: women tends to be at a higher risk than men
• Age: As one ages, it increases the risk of acquiring it.
• Race: White and Asian people are at a high risk of developing it
• Body mass frame: Individuals with smaller body frame are at higher risk as they have less bone mass.
• Low sex hormones: men with less testosterone; women with less estrogen
• Increased thyroid hormones: Overstimulated thyroid can increase bone loss.
• Less calcium intake: decreases bone density, early bone loss.
• Eating disorder: Poor nutrition and being underweight can weaken the bones
• Underwent gastrointestinal surgery: Individuals who have less abdominal surface to absorb nutrients, especially calcium are at a higher risk of developing it.
• Individuals taking medications for seizures, gastric reflux, cancer, and transplant rejection.
• Individuals with the following medical conditions: Celiac disease, Inflammatory bowel disease, Kidney or liver disease, Cancer, Lupus, Multiple myeloma, and Rheumatoid arthritis
• Sedentary lifestyle: Being active and engaging in exercise are good for the bones.
• Excessive alcohol and/or tobacco consumption: Individuals with this lifestyle are at a higher risk

2.Osteoporosis' distinctive feature is a decrease of bone mass as a result of an imbalance between bone resorption and bone formation. This imbalance may be due to various factors like lifestyle, nutrition, age-related, genetic predisposition, medications, and existing medical condition. Normally, bone formation and bone resorption are on a fair balance. As this balance is not maintained - decrease bone formation and increased bone resorption - could result to osteoporosis.

3.

a. Bone density test: It scan the body and uses x-ray images to measure bone density and fracture risks.

b. Blood test to measure calcium levels, thyroid function, and testosterone/estrogen levels.

4.Anticipated Ineffective Behaviors (such as calcium and/or vitamin D deficiency; little or no exercise, especially weight-bearing exercise; alcohol abuse; cigarette smoking) are not clinical manifestations but are still risk factors until such a time that individuals develop the disease due to these behaviors.

5.

a. Medical

• Administration of biphosphonates, as ordered by the physician. This medication reduces bone resorption. Thus, maintaining bone density and lessens likelihood of fractures to occur.
• Administration of Calcium and Vitamin D supplements as ordered by the physician.
• Administration of hormones to maintain bone density like Selective oestrogen receptor modulators (SERMs), parathyroid hormone, and testosterone.

b. Nursing

• Emphasize on the importance of adequate exposure to sunlight to prevent vitamin D deficiency.
• Rationale: The patient should be outside 15 minutes daily.
• Instruct patient to perform gentle exercises.
• Rationale: Exercise can help build strong bones and slow bone loss. Strength-training exercises should be combined with weight-bearing exercises. Strength training helps in bone and muscle strength.
• Limit alcohol intake.
• Rationale: Consuming more than two alcoholic drinks a day may decrease bone formation and reduce the body's ability to absorb calcium.
• Have a balanced diet.
• Rationale: A diet high in nutrients that support skeletal metabolism: vitamin D, calcium, and protein.
• Limit caffeine intake.
• Rationale: Limit the amount of caffeinated beverages to about two to three cups of coffee a day.
• Assess the patient's functional ability for mobility and note changes.
• Rationale: Identifies problems and helps to establish a plan of care.
• Assist patient with walking.
• Rationale: Preserves the patient's muscle tone and helps prevent complications of immobility.
• Instruct patient or assist with active and passive ROM exercises of affected and unaffected extremities.
• Rationale: Increases bloodflow to muscles and bone to improve muscle tone, maintain joint mobility; prevent contractures or atrophy and calcium resorption from disuse
• Assist with self-care activities.
• Rationale: Improves muscle strength and circulation, enhances patient control in the situation, and promotes self-directed wellness.
• Assess patient's knowledge of disease, diet, medication, and exercise program to arrest the progression of bone deterioration.
• Rationale: Provides a basis for teaching and techniques to promote compliance. 
• Assess the patient's understanding of osteoporosis.
• Rationale: Most individuals with osteoporosis are not diagnosed until an acute fracture occurs.
• Teach patient about nutrition and calcium intake.
• Rationale: Adequate calcium helps to prevent osteoporosis in women with a small frame, increased age, Asians, and Caucasians.

Nursing diagnosis

Impaired physical mobility related to bone loss as evidenced by fine line fracture on lower extremity.

Imbalanced nutrition: less than body weight related to inadequate calcium as evidenced by fracture on lower extremity.

Knowledge deficit related to lack of exposure to information regarding the condition as evidenced by multiple information requests.