1. LIST TWO SHORT AND LONG TERM NURSING DIAGNOSES FOR OSTEOPOROSIS FOR A FRACTURED 86 YEAR OLD WOMAN
2. LIST TWO GOALS EACH FOR THE DIAGNOSES
3. EXPLAIN THREE NURSING INTERVENTIONS FOR THE DIAGNOSES
4. HOW WILL YOU EVALUATE THE EFFECTIVENESS OF THE INTERVENTION
5. WRITE THE PATHOPHYSIOLOGY OF THE DIAGNOSES.
6.  

Diagnosis:

1.Impaired physical Mobility

Goals:

• Patient will maintain functional mobility, as long as possible within limitations of disease process.
• Patient will have a few, if any, complications related to immobility as disease condition progresses.

Nursing Intervention:

• Provide range of motion exercises every shift. Encourage active range of motion exercises. It Helps to prevent joint contractures and muscle atrophy.
• Assist patient with walking if at all possible, utilizing sufficient help. A one or two-person pivot transfer utilizing a transfer belt can be used if the patient has a weight-bearing ability. It preserves the patient's muscle tone and helps prevent complications of immobility.
• Encourage use of isometric exercises starting with the unaffected limb. Isometrics contract muscles without bending joints or moving limbs and help maintain muscle strength and mass. Note: These exercises are contraindicated while acute bleeding and edema are present.
• Reposition periodically and encourage coughing and deep-breathing exercises. It prevents or reduces the incidence of skin and respiratory complications (decubitus, atelectasis, pneumonia).

Evaluation:

The patient maintains functional mobility and patient will have a few, if any, complications related to immobilty as disease condition progresses.

2.Imbalanced Nutrition: Less Than Body Requirements

Goals:

• Patient will demonstrate adequate intake of calcium and vitamin D.

Nursing Interventions:

• Instruct recommended daily intake for calcium. Premenopausal women (19-50 years old) need 1,500 mg of calcium daily. After menopause, the requirement is 1,200 mg daily. Getting enough vitamin D is equally important as getting enough calcium because vitamin D aids in the absorption of calcium and improves muscle strength.
• Instruct on the importance of adequate exposure to sunlight to prevent vitamin D deficiency. The patient should be outside 15 minutes daily.
• Instruct patient to perform gentle exercises. 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.
• Provide a balanced diet. A diet high in nutrients that support skeletal metabolism: vitamin D, calcium, and protein.

Evaluation:

Patient demonstrates adequate intake of calcium and vitamin D.

*There is no pathophysiology of the diagnosis, I think you mean the pathophysiology of the disease (Osteoporosis).

Pathophysiology of Osteoporosis:

Osteoporosis is characterized by reduced bone mass, deterioration of bone matrix, and diminished bone architectural strength.

• Reduced total bone mass. Normal homeostatic bone turnover is altered; the rate of bone resorption that is maintained by osteoclasts is greater than the rate of bone formation that is maintained by osteoblasts, resulting in a reduced total bone mass.
• Progression. The bones become porous, brittle, fragile; they fracture easily under stresses that would not break normal bone.
• Postural changes. The postural changes result in relaxation of the abdominal muscles and a protruding abdomen.
• Age-related losses. Calcitonin and estrogen decrease with aging, while parathyroid hormone increases, increasing bone turnover and resorption.
• Consequence. The consequence of these changes is net loss of bone mass over time.

Step-by-step explanation

Additional Nursing Diagnoses:

Deficient knowledge

Goals:

• Patient will achieve increased knowledge and compliance with medical regimen to minimize bone demineralization and injury.
• Patient will be able to perform daily exercises within identified limitations and to prevent further bone loss or deterioration.

Nursing Interventions:

• Assess patient's knowledge of disease, diet, medication, and exercise program to arrest the progression of bone deterioration. Provides a basis for teaching and techniques to promote compliance. Disease is not usually detected until 24-40% of calcium in bone is lost.
• Assist to plan an exercise program according to capabilities; to avoid flexion of the spine and wear a corset if appropriate (walking is preferred to jogging). Exercise will strengthen bone. Vertebral collapse is common and corset provides support.
• Promote understanding of osteoporosis and the treatment regimen. Patient teaching focuses on factors influencing the development of osteoporosis, interventions to arrest or slow the process, and measures to relieve symptoms.

Evaluation:

Patient acquired knowledge about osteoporosis and the treatment regimen.