NURSE-UN 1243 Adult and Elder Nursing 3 Week 7 - Musculoskeletal Disorders
• Learning Outcomes The student will be able to:
– Implement health promotion practices related to musculoskeletal disorders identified by Healthy People 2030 for the adult & older adult population.
• Reduce the pro...
nurse un 1243 adult and elder nursing 3 week 7 musculoskeletal disorders
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NURSE-UN 1243
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NURSE-UN 1243 Adult and Elder Nursing 3 Week 7 - Musculoskeleta
Disorders
• Learning
Outcomes The student
will be able to:
– Implement health promotion practices related to
musculoskeletal disordersidentified by Healthy People 2030 for
the adult & older adult population.
• Reduce the proportion of older adults with osteoporosis
• Increase the number of adults who get screened for osteoporosis
• Reduce hip fractures among older adults
• Reduce pain & disability from arthritis
– Demonstrate clinical decision making based on the integration of
information from multiple sources, including the patient, inter-
professional team, & the best available evidence for patients with
musculoskeletal disorders (Osteoporosis, Osteoarthritis, Hip
Fracture).
– Advocate for high quality, safe, & culturally competent patient
centered care forhospitalized patients with musculoskeletal
disorders.
Osteoporosis (OP)
◼ Chronic metabolic disease in which bone loss causes decreased density
and possible fracture; “silent disease/thief”--often discover at time of
fracture
◼ Occurs when osteoclastic activity is greater than osteoblastic activity
(breakdown faster than building)
◼ Bone Mineral Density (BMD) decreases rapidly post-menopause
◼ More common in women because less estrogen (protective against bone loss),
after menopause , Calcium and vitamin d deficiency. Less
exercise(decreased activity).
◼ vit d is needed for Ca absorption
◼ Bone resorption happens earlier than we thought---in our 30s!
◼ Testosterone in men builds bone
◼ Incidence/Prevalence
, ◼ 10 million Americans (1 in 10 Americans) have the disease and 54
million more have osteopenia and at risk for developing
osteoporosis
◼ White thin women are likely to develop osteoporosis at an early age
Classifications of Osteoporosis **Bucco says don’t have to know primary vs secondary
▪ Primary osteoporosis (post menopausal) occurs most commonly in
postmenopausalwomen and men in their 60s and 70s.
▪ 1 in 4 men > 50 are will have a osteoporosis related fracture.
▪ Secondary osteoporosis results from an associated medical condition such as
hyperparathyroidism (PTH usually makes sure blood calcium is not
too low), long-term drug therapy, long-term immobility, and chronic
drug use such ascorticosteroids, heparin, anticonvulsants
, ▪ Regional osteoporosis occurs when a limb is immobilized.
Risk Factors
◼ Older age - mainly women
◼ Female gender men are often underdiagnosed bc don’t go for bone density tests
◼ Familial history
◼ Low body weight, thin build -heavier people have more protection. Obese
women store estrogen in tissues for longer period of time, hence,
maintain serum Ca
◼ Chronic low calcium and/or Vitamin D intake
◼ Estrogen/Androgen deficiency
◼ Smoking
◼ High alcohol intake
◼ Lack of physical exercise or prolonged immobility
◼ White/ Asian ethnicity
◼ Long term use of steroids, thyroid replacement, heparin, long-acting
sedatives & antiseizure drugs
◼ Studies have shown that some enzyme-inducing Anti Epileptic Drugs may
increase the levels of chemicals in the liver that destroy vitamin D,
reducing theamount of vitamin D in the body
◼ Men after age 50 have decreased testosterone and are at risk of osteoporosis
◼ underdiagnosed--less likely to go for bone density tests
Health Promotion/Illness Prevention
▪ Teaching should begin with young women who begin to lose bone after 30 years of age
▪ The focus of osteoporosis prevention is to decrease modifiable risk factors.
▪ Ensure adequate nutrition
▪ dark green veggies, dairy for calcium
▪ Avoid sedentary lifestyle
, ▪ Continue a program of weight-bearing exercises--prevention
▪ When any of the previous drugs are prescribed, teach the patient about
the risk of osteoporosis. i.e. synthroid, steroids, heparin, long-acting
sedatives, anti seizure meds
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