Osteoporosis is a systemic metabolic disease characterized by low bone mass and microstructural damage, leading to increased bone fragility and susceptibility to fracture.
The disease is caused by genetic, endocrine, and lifestyle factors: Aging and the sudden drop in estrogen levels after menopause lead to increased bone resorption, while insufficient calcium and vitamin D intake and lack of exercise accelerate bone loss. The prevalence in people aged 50 and older is 19.2% (32.1% in women), and in those aged 65 and older, it reaches 32.0% (51.6% in women). Diagnosis is based on bone density testing (2.5 standard deviations below the normal level for young adults).
Nursing Assessment
- Assess the patient for bone pain. Severe symptoms include lower back pain or generalized pain, which worsens with exertion or activity and reduces weight-bearing capacity.
- Assess for shortened height or kyphosis, which can occur due to compression and deformation of the vertebrae, leading to stiffness and, in severe cases, kyphosis.
- Monitor the patient for fractures induced by minor activity or trauma, such as coughing, sneezing, bending, carrying weights, falling, or being squeezed. These fractures are called brittle fractures and are the most serious and common complication of osteoporosis.
- Observe the patient for decreased respiratory function, cardiovascular dysfunction, or symptoms such as chest tightness, shortness of breath, and difficulty breathing.
Nursing Measures
- Under a doctor's guidance, appropriate outdoor activities and weight-bearing exercises, such as walking, tennis, and weightlifting, can reduce bone loss and prevent osteoporosis. When patients are resting in bed with pain, they should use a lightly padded board and lie supine or sideways.
- Promote the consumption of foods rich in calcium and vitamin D, such as soy products, dried shrimp, cod liver oil, eggs, and liver. Avoid foods high in phosphorus, such as braised pork and soft drinks.
- Medication and care: Calcium supplements should be taken after dinner or before bedtime, and should not be taken with green leafy vegetables. Increase your water intake and prevent constipation. Regularly check your blood calcium level and adjust medication dosage accordingly. When using calcitonin, observe for signs of hypocalcemia and hyperthyroidism. When using estrogen, closely monitor changes in the endometrium and pay attention to vaginal bleeding.
- Observe the patient's overall skeletal pain. Use a back brace, tights, or other methods to restrict muscle mobility. Hot baths, massage, and back scrubs can help relieve pain. Elderly patients with severe pain should use analgesics and muscle relaxants.
- For patients with fractures, assist with regular turning to prevent the development of pressure ulcers. Patients with spinal fractures should sleep on a hard bed, with pillows placed on the affected vertebral kyphosis. Sitting up is prohibited. Turning should be done axially, with the shoulder, waist, and vertebrae aligned. For patients with femoral neck fractures, place the affected limb in a neutral abduction position to avoid excessive rotation and traction. Provide early guidance on functional exercises for the affected limb.
- Create an environment conducive to sleep and rest for the elderly. Actively identify the causes of sleep disorders, systematically arrange treatment and nursing care, and supplement with sleep-inducing medications when necessary.
- Encourage the elderly to express their inner feelings and provide guidance on clothing choices, helping them improve their appearance and enhance their self-confidence.
Health Education
- Provide elderly patients with disease information to prevent complications such as fractures.
- Patiently explain the effects and side effects of medications.
- Promote the consumption of calcium-rich foods and avoid foods high in phosphorus.
- Patients experiencing bone pain should rest in bed, use a back brace, tights, or other methods to limit muscle mobility, and take pain medications regularly.
- Follow the doctor's advice and maintain appropriate weight-bearing exercise and outdoor activities.