Make a nursing care plan 2:29 4ull : O1 FilesOSTEOPOROSIS CASE SCENARIO...OSTEOPOROSIS. A 52-year-old white female experiencing diffuse bone pain over the past severalyears after menopause. She has a history of fractures to her left hip and wrist. Shestates, "The pain is becoming worse and it is keeping me from doing my dailyactivities." She currently complains that any weight-bearing activity causes her severediscomfort.She is not taking hormone replacement or any other medication. She has been using asoy herbal supplement and vitamin E 400 IU daily. She knows the importance ofShe is up to date on all her gynecological exams, and past mammograms have beennormal as have her health maintenance exams. She does not smoke or use alcohol. Hersystem reviews are unremarkable excluding today's complaint.Her family history reveals that her mother had a history of anxiety, osteoporosis, non-insulin dependent diabetes and hypertension. Her father has hypertension but is inotherwise good health. There is no history of breast disorders or arthritis, thyroid orany other metabolic disorder.preventive healthcare.She lives alone in a one-story house and works at a car plant. She has three childrenand one grandchild. Her daughter lives in close proximity to her so she is able to enjoyvisiting and caring for her 3-year-old grandson occasionally. She has no exercise routineand admits to a somewhat sedentary lifestyle. She admits to eating a vitamin-poordiet.experienced menopause around the age of 47 when her menstrual periods stopped. Herprevious physician recommended no hormone replacement because she was not sufferingfrom any menopausal symptoms. However, she now reports having "hot spells" atdifferent times throughout the day with some trouble sleeping for the past 3 months.She also complains of some vaginal dryness that she admits is bothersome.Her chief complaint is severe back pain and the inability to do simple chores such aslifting grocery bags and her grandchild without pain.Physical ExaminationUpon physical exam, she is afebrile with unremarkable findings with exception to themusculoskeletal system. She weighs 132 pounds and is 5 feet 5 inches. At her last exam 8months ago, she was 5 feet 6 inches.Upon palpation, guarding and tenderness are present in the cervical, thoracic andlumbar spine with limited range of motion. No spasticity, rigidity or flaccidity is present.She has active range of motion in all joints, with no edema, redness or heat present injoint areas. She exhibits notable guarding and rigidity performing range of motion oflower and upper back areasThere is also noticeable guarding with some limitation of movement at the cervicalspine area. She is able to endure the exam with noticeable painful expressions on herface when asked to do range of motion with back, guarding and tenderness noted atcervical spine area. There is no presence of dowager's hump. She has no evidence ofherniation or disc displacement upon inspection. No scoliosis or lordosis is present.Her preliminary urinalysis and CBC are unremarkable.Differential DiagnosisHer symptoms indicate post-menopausal osteoporosis. In addition to physical findings, . has risk factors ofincreased age, heredity, small body size, thin stature and being white.To confirm the diagnosis and rule out other medical conditions, lab tests were obtained to assess hormone,calcium, vitamin D, blood cholesterol levels and thyroid function. Also ordered were a sedimentation rateto check for arthritis, an X-ray of her back and a dual energy X-ray absorptiometry (DEXA) scan to rule outinjury. DEXA scan is the gold standard in diagnosis of osteoporosis.Diagnostic tests revealed a lack of estrogen and calcium. The X-ray of her back showed degenerativechanges but no disc dislocations or herniations. The DEXA scan showed a T score of -2.9. AT score greaterthan -2.5 confirms a diagnosis of osteoporosis and indicates hormonal treatment should be initiated."Treatment PlanTreatment includes a calcium supplement 1200 mg with vitamin D daily, Fosamax (alendronate sodium) 10mg daily and Premarin (conjugated estrogens) 0.625 mg daily. This routine treatment should provideadequate relief and help prevent future bone loss. The Women's Health Initiative study is the first trialwith definitive data supporting the ability of postmenopausal hormones to prevent fractures at the hip,vertebrae and other sites.Patient Education42After tolerance of medications and symptom relief have been achieved, a walking routine, weight-bearing exercise and education on a well-balanced diet are introduced. The goal of walking and weight-bearing exercises is to increase bone mass and muscle endurance.In addition to the nutritional education, T.S. is given reinforcement on continuing to avoid alcohol andcigarette smoking. Education also includes the side effects of taking estrogen and Fosamax and theimportance of following this treatment plan to achieve a good outcome for her, as osteoporosis is adebilitating condition.OSTEOPOROSIS 2A 37-year-old man presented to the emergency department atour hospital on October 2012 with a 4-month history ofworsening lower back pain. There was no history of trauma orfalls. He was unemployed a ivemith hiemther H ok nomedications or supplements, did not smoke, consume excessive

Osteoporosis- This is a disorder of bones in which they becomes fragile as well as weak. In such…

OSTEOPOROSIS . A 52-year-old white female experiencing diffuse bone pain over the past several years after menopause. She has a history of fractures to her left hip and wrist. She states, "The pain is becoming worse and it is keeping me from doing my daily activities." She currently complains that any weight-bearing activity causes her severe discomfort. She is not taking hormone replacement or any other medication. She has been using a soy herbal supplement and vitamin E 400 IU daily. She knows the importance of She is up to date on all her gynecological exams, and past mammograms have been normal as have her health maintenance exams. She does not smoke or use alcohol. Her system reviews are unremarkable excluding today's complaint. Her family history reveals that her mother had a history of anxiety, osteoporosis, non- insulin dependent diabetes and hypertension. Her father has hypertension but is in otherwise good health. There is no history of breast disorders or arthritis, thyroid or any other metabolic disorder. preventive healthcare. She lives alone in a one-story house and works at a car plant. She has three children and one grandchild. Her daughter lives in close proximity to her so she is able to enjoy visiting and caring for her 3-year-old grandson occasionally. She has no exercise routine and admits to a somewhat sedentary lifestyle. She admits to eating a vitamin-poor diet.

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ