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H&C Ch 37 OP
Osteoporosis
| Question | Answer |
|---|---|
| What is the condition that is a precursor to osteoporosis ? | Osteopenia |
| Who has a higher prevalence of fractures related to osteoporosis? | Females 1 out of 3 , versus males 1 out of 5 p.991 |
| A 15 year old male has been working out and is inquiring if he has reached peak bone mass. What would you tell him ? | no he has not , peak bone mass is between 18 and 25 y/o p.991 |
| What are the 6 factors that affect bone mass? | genetics, nutrition, physical activity, medications, endocrine status, and general health p.991 |
| Who manifests osteoporosis at a later age and why | Males develop larger heavier bones therefore they manifest osteoporosis at a more advanced age p.991 |
| Primary osteoporosis occurs in females after ___________ | menopause p.991 |
| What 2 factors commonly contribute to development of osteopenia ? | failure to develop peak bone mass and low vitamin D levels p. 991 |
| What interventions are recommended to help decrease the risk of fractures and late in life disability ? | regular weight bearing exercise, lifestyle modifications (reduce caffeine, tobacco, carbonated soft drinks and alcohol) |
| What is a major source of Vitamin D naturally | Sunlight |
| How much direct sunlight daily is recommended for adults ? | 15-30 minutes daily |
| What is the recommended daily does of vitamin D orally | 400U to 1000U daily |
| A 68 year old patient reports they have a normal vitamin D level. They are taking 2,000 units of vitamin D daily becuase they do not want to get osteoporosis. What education would you provide this person ? | if you have a normal vitamin D level taking a supplement may cause a vitamin d toxicity |
| A 17 year old paitent consumes a diet calculated to be approximately 900 mg/day of calcium with vitamin D. What education would you provide regarding calcium intake for this patient ? | consume a diet with calcium between 1,000 and 1300 mg / day p. 992 |
| A 22 year old is an active swimmer, swimming daily during the week and attends meets on the weekends. This is her only form of exercise. What education would you provide regarding exercise and bone health ? | swimming is not weight bearing - she should do weight bearing exercises daily p. 992 |
| Which of these interventions is appropriate for people in menopause or post menopause? 1. look for home hazards contributing to falls 2. use good body mechanics 3. avoid balance exercises because it could make them fall | 1 and 2 are correct, 3 is in correct they should work on balance exercises p.992 |
| True or False - males do not need to participate in screening for osteoporosis | False males should be screened if risk factors or assessment (loss of height, pathological fracture etc) |
| What is the difference between primary and secondary osteoporosis ? | primary is related to menopause, secondary is the result of medications or diseases that affect bone metabolism |
| Who is MORE likely to have secondary osteoporosis ? | males , often attributed to steroid and excdessive alcohol intake |
| What other factors place patients at risk for secondary osteoporosis ? (there are 7) | |
| What is the condition that is a precursor to osteoporosis ? | Osteopenia |
| Who has a higher prevalence of fractures related to osteoporosis? | Females 1 out of 3 , versus males 1 out of 5 p.991 |
| A 15 year old male has been working out and is inquiring if he has reached peak bone mass. What would you tell him ? | no he has not , peak bone mass is between 18 and 25 y/o p.991 |
| What are the 6 factors that affect bone mass? | genetics, nutrition, physical activity, medications, endocrine status, and general health p.991 |
| Who manifests osteoporosis at a later age and why | Males develop larger heavier bones therefore they manifest osteoporosis at a more advanced age p.991 |
| Primary osteoporosis occurs in females after ___________ | menopause p.991 |
| What 2 factors commonly contribute to development of osteopenia ? | failure to develop peak bone mass and low vitamin D levels p. 991 |
| What interventions are recommended to help decrease the risk of fractures and late in life disability ? | regular weight bearing exercise, lifestyle modifications (reduce caffeine, tobacco, carbonated soft drinks and alcohol) |
| What is a major source of Vitamin D naturally | Sunlight |
| How much direct sunlight daily is recommended for adults ? | 15-30 minutes daily |
| What is the recommended daily does of vitamin D orally | 400U to 1000U daily |
| A 68 year old patient reports they have a normal vitamin D level. They are taking 2,000 units of vitamin D daily becuase they do not want to get osteoporosis. What education would you provide this person ? | if you have a normal vitamin D level taking a supplement may cause a vitamin d toxicity |
| A 17 year old paitent consumes a diet calculated to be approximately 900 mg/day of calcium with vitamin D. What education would you provide regarding calcium intake for this patient ? | consume a diet with calcium between 1,000 and 1300 mg / day p. 992 |
| A 22 year old is an active swimmer, swimming daily during the week and attends meets on the weekends. This is her only form of exercise. What education would you provide regarding exercise and bone health ? | swimming is not weight bearing - she should do weight bearing exercises daily p. 992 |
| Which of these interventions is appropriate for people in menopause or post menopause? 1. look for home hazards contributing to falls 2. use good body mechanics 3. avoid balance exercises because it could make them fall | 1 and 2 are correct, 3 is in correct they should work on balance exercises p.992 |
| True or False - males do not need to participate in screening for osteoporosis | False males should be screened if risk factors or assessment (loss of height, pathological fracture etc) |
| What is the difference between primary and secondary osteoporosis ? | primary is related to menopause, secondary is the result of medications or diseases that affect bone metabolism |
| Who is MORE likely to have secondary osteoporosis ? | males , often attributed to steroid and excdessive alcohol intake |
| What other factors place patients at risk for secondary osteoporosis ? (there are 7) | |
| What is the condition that is a precursor to osteoporosis ? | Osteopenia |
| What is the condition that is a precursor to osteoporosis ? | Osteopenia |
| Who has a higher prevalence of fractures related to osteoporosis? | Females 1 out of 3 , versus males 1 out of 5 p.991 |
| Who has a higher prevalence of fractures related to osteoporosis? | Females 1 out of 3 , versus males 1 out of 5 p.991 |
| A 15 year old male has been working out and is inquiring if he has reached peak bone mass. What would you tell him ? | no he has not , peak bone mass is between 18 and 25 y/o p.991 |
| A 15 year old male has been working out and is inquiring if he has reached peak bone mass. What would you tell him ? | no he has not , peak bone mass is between 18 and 25 y/o p.991 |
| What are the 6 factors that affect bone mass? | genetics, nutrition, physical activity, medications, endocrine status, and general health p.991 |
| Who manifests osteoporosis at a later age and why | Males develop larger heavier bones therefore they manifest osteoporosis at a more advanced age p.991 |
| Primary osteoporosis occurs in females after ___________ | menopause p.991 |
| What 2 factors commonly contribute to development of osteopenia ? | failure to develop peak bone mass and low vitamin D levels p. 991 |
| What interventions are recommended to help decrease the risk of fractures and late in life disability ? | regular weight bearing exercise, lifestyle modifications (reduce caffeine, tobacco, carbonated soft drinks and alcohol) |
| What is a major source of Vitamin D naturally | Sunlight |
| Who manifests osteoporosis at a later age and why | Males develop larger heavier bones therefore they manifest osteoporosis at a more advanced age p.991 |
| Primary osteoporosis occurs in females after ___________ | menopause p.991 |
| What 2 factors commonly contribute to development of osteopenia ? | failure to develop peak bone mass and low vitamin D levels p. 991 |
| What interventions are recommended to help decrease the risk of fractures and late in life disability ? | regular weight bearing exercise, lifestyle modifications (reduce caffeine, tobacco, carbonated soft drinks and alcohol) |
| What is a major source of Vitamin D naturally | Sunlight |
| How much direct sunlight daily is recommended for adults ? | 15-30 minutes daily |
| What is the recommended daily does of vitamin D orally | 400U to 1000U daily |
| A 68 year old patient reports they have a normal vitamin D level. They are taking 2,000 units of vitamin D daily becuase they do not want to get osteoporosis. What education would you provide this person ? | if you have a normal vitamin D level taking a supplement may cause a vitamin d toxicity |
| A 17 year old paitent consumes a diet calculated to be approximately 900 mg/day of calcium with vitamin D. What education would you provide regarding calcium intake for this patient ? | consume a diet with calcium between 1,000 and 1300 mg / day p. 992 |
| A 22 year old is an active swimmer, swimming daily during the week and attends meets on the weekends. This is her only form of exercise. What education would you provide regarding exercise and bone health ? | swimming is not weight bearing - she should do weight bearing exercises daily p. 992 |
| Which of these interventions is appropriate for people in menopause or post menopause? 1. look for home hazards contributing to falls 2. use good body mechanics 3. avoid balance exercises because it could make them fall | 1 and 2 are correct, 3 is in correct they should work on balance exercises p.992 |
| True or False - males do not need to participate in screening for osteoporosis | False males should be screened if risk factors or assessment (loss of height, pathological fracture etc) |
| What is the difference between primary and secondary osteoporosis ? | primary is related to menopause, secondary is the result of medications or diseases that affect bone metabolism |
| Who is MORE likely to have secondary osteoporosis ? | males , often attributed to steroid and excdessive alcohol intake |
| What other factors place patients at risk for secondary osteoporosis ? (there are 7) | Specific diseases, anticonvulsants, thryoid replacement agents, antiestrogens, androgen inhibitors, SSRIs and PPIs |
| A patient has been taking omeprazole for GERD for 2 years. Their bone density study shows osteoporosis. They stop the medication. When will bone restoration occur ? | they may never regain the bone lost, the progression of bone loss is halted when they stop the medication |
| Who has a higher mortality rate after a hip fracture ? Male or female | males p. 992 |
| Define a fragility fracture | it occures when a person falls from natural height (or lower) or with low velocity (example while leaning over to pick up something from the floor and they fall forward slowly) |
| What is a often the first detectable sign that a patient has osteoporosis or vertebral fracture ? | loss of height p. 992 |
| How much calcium should a post menopausal or older adult consume ? | 1,200 mg daily with 800 IU of vitamin D daily p. 992 |
| A 78 year old post menopausal female patient is consuming 1 glass of milk, cottage cheese and 1,200 mg of calcium with vitmain D daily. What education would you provide this patient ? | large quantities (above 1200 mg daily) of calcium puts them at risk for renal calculii and rate of fractures does NOT decrase in females who are post menopausal and taking calcium supplements |
| Osteoblasts do what ? | build bone p. 993 |
| Osteoclasts do what ? | resorb bone p. 993 |
| What body posture is noted with osteoporosis ? | kyphosis |
| The type of fracture common with osteoprosis in the thoracic and lumbar spine are what ? | compression fractures p. 933 |
| True or false - osteoporosis is typically very painful | false |
| age related bone loss begins at what decade of life ? | the fourth p. 993 |
| An oophorectomy puts a patient at risk for bone loss - why | because oophorectomy removes ovaries and estrogen is dramatically reduced |
| What ethnicities are at highest risk for osteoporosis ? | asian and caucasian females |
| True or False Black females have higher mineral mass when younger they are at risk for osteoporosis for what reason ? | due to prevalence of sickle cell and autoimmune diseases in this population |
| Aromatase inhibitors, do they help treat osteoporosis or do they increase the risk of developing osteoporosis | They put a patient at risk for osteoporosis |
| Why does bariatric surgery put a patient at risk for osteoporosis ? | if they have a bypass the duodenum is bypassed which is the site for calcium absorption |
| Why do autoimmune diseases contribute to poor bone health ? | many are associated with nutritional deficiencies (e.g. celiac, autoimmune liver disease, many are prescribed corticosteroids, or are sedentary |
| A patient who is wheelchair bound is at risk for osteoporosis , why ? | bone formation is enhanced by the stress of weight and muscle activity |
| what exercises are recommended for developing and maintaining bone mass ? | resistance and impact exercises |
| True or False : early osteoporosis is detectable on Xray | False p.994 |
| How is osteoporosis diagnosed ? | by DEXA scan (dual energy xray absorptiometry p.994 |
| When is DEXA scan recommended for screening ? | females older than 65 years, post menopausal and older than 50 with risk factors |
| What is the recommendation for routine screening of males older than 70 ? | there is no recommendation for this p. 994 |
| What is the preferred risk estimator for males ? "FRAX" or "MORES" | MORE - male osteoporosis risk estimation score |
| True or False - diabetes is a risk factor for deveoping osteoporosis | TRUE |
| The nurse can expect to see what lab tests ordered for evaluation of risk for bone loss | serum calcium, serum phosphate, serum alkaline phosphatase, urine calcium excretion, urinary hydrocyproline excretion, hematocrit, ESR and XR |
| What is the amount of daily weight bearing exercise ? | 20 to 30 minutes |
| True or False : Hormone therapy for post menopausal women can be used for primary prevention of bone loss | FALSE p. 994 |
| Teaching instructions for taking calcium should include: | take with vitamin d , with meals or with a beverage high in vitamin C |
| A patient is taking 1200 mg orally daily. They take this dosage in the a.m. with orange juice. What additional education should this patient receive ? | the daily dose should be split, 500 mg or higher is poorly absorbed |
| Drugs used to treat osteoporosis include: | bisphosphonates, estrogen agonist/antagonists, RANKL inhibitors, sclerostin inhibitors |
| patients with highest risk for fragility fractures and cardiovasular risk factors are not prescribed which medication? | romosozumab |
| True or False: patients with osteopenia will benefit from taking bisphosphonates | FALSE p. 994 |
| A patient is prescribed a bisphosphonate,what education would you provide | take on empty stomach, only with water, sit upright for 30 minutes after ingestion |
| Bisphosphonates are contraindicated in patients with what medical conditions ? | Barrett esophagus, low serum calcium levels and pregnancy |
| What rare adverse effects are associated with taking bisphosphonates ? | osteonecrosis of the jaw and subtrochanteric fractures |
| True or False : asymptomatic osteoporotic compression fractures are surgically treated | FALSE |
Created by:
Kelly Quijano