Question

NR304 Musculoskeletal Case Study 5. What general recommendations would the nurse make to the client to promote musculoskeletal health and reduce safety risks? (List at least four) Case Study #2: A 68 y/o female client has come to the healthcare provider's office with concerns of osteoporosis. She has been becoming more kyphotic and had already lost 1" in height over the last few years. She is 20 years postmenopausal and has never taken hormone replacement therapy. The client is a former secretary and spends much of her time now watching television. She stopped smoking 30 years ago. She has an occasional alcoholic beverage and drinks a cup of coffee each day 1. Identify and discuss risk factors that predispose her to osteoporosis (List at least six and provide rationales) What recommendations would the nurse give this client to prevent further worsening of her symptoms or condition? (List at least three and provide rationales) 2. 3. List three nursing diagnoses for this client with at least one AEB. Six months later the client slipped on the ice, fell down, and broke her hip. She was admitted to the hospital and underwent surgery for an open reduction and internal fixation (ORIF) to repair the fracture. She is currently two days post-op and having pain issues. She takes multiple doses or narcoties daily instead opting to stay in becd and refuses to ambulate with physical therapy

Answer 1

5. Measures to promote musculoskeletal health and reduce safety risk.

                       * Regular exercises help to maintain healthy muscles and joints.

                       * Give preference to protein and vitamin D containing foods to maintain

                          skeletal and muscle growth.

                       * Avoid doing vigorous activities which may cause injury to muscles and bone.

                       * Morning sunbath help to get enough vitamin D for bone growth.

1. Risk factor predispose her to osteoporosis.

                       * Age

                              * When age increases remodellng process of bone become reduces which

                                 leads to osteoporosis.

                     * Menopause.

                              * After menopause estrogen level decreases which result in lose more bone

                                than they replace leads to osteoporosis.

                     * Smoking

                               * Smoking result in loss of bodys ability to use calcium,estrogen and vitamin D

                                  due to effect of nicotine which leads to osteoporosis.

                     * Sedentory life style.

                                * Sedentary life style leads to muscular atropy and bone loss happen rapidly

                                   leads to osteoporosis.

                     * Alcohol use.

                                * Alcohol use stop the remodelling process of bone and increase loss of calcium

                                  from the body leads to osteoporosis.

                      * Lack of vitamin D

                                * Patient spens much time for watch TV so lack of exposure to sunlight which result

                                  in vitaminD deficiency and lead to osteoporosis.

2. Recommendation for prevent further worsening of symptoms.

                             * Continue hormone replacement therapy to maintain normai

                                estrogen level.

                             * Give priority to protein rich foods to maintain calcium,vitamin D

                                level in the body for health of bone and muscle.

                             * Avoid use of coffee due to it's negative effect on bone density.

3, Nursing Diagnoses.

                     * Deficient knowledge of osteoporotic process related to lack of exposure as

                       evidenced by not taking hormone replacement therapy.

                     * Risk for injury or fracture related to osteoporotic bone.

                     * Anxiety related disease condition.

4. Cocerns about the patient.

                     * Patient may develop side effects of narcotics like vomitting,nausea,constipation.

                     * Refuse to physiotherapy negatively affect the healing process of bone.

                     * Stay in the bed continuosly leads to pressure ulcers.

                     * Continous stay in bed leads to constipastion because of immobility.

                     * Lack of physical movement of patient leads to muscular atropy.

   5.Goals client need to meet before discharge.

                  * Patient shouls get knowledge about osteoporosis and treatment regimen.

                  * Patient get relieve from pain due to fracture.

                  * Patient should able to avoid anxiety and maintain normal mental status.