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NUR 5300 - Module 8 - Osteoporosis case study - Course Hero.docx

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UNIVERSITY OF CENTRAL MISSOURIDepartment of NursingNursing 5300Spring & Fall SemestersAdvanced PathophysiologyOsteoporosis Case Study (30 points possible)Ms.Barlow, a 65-year-old Caucasian female has a follow up appointment with your clinic aftervisiting the emergency department for a wrist fracture. You order a bone mineral density (BMD)testing, and the results of the BMD test show a T-score of -3.0.Past medical history includes mild hypertension which is currently managed with propranolol.She also takes a daily multivitamin. She drinks and smokes occasionally and she lives alone andhas no children or spouse.Please address all of the following.1.Discuss the pathophysiology of osteoporosis, risk factors, and common presenting signsand symptoms. Be specific in your discussion of processes involved.According to Butler (2019), that pathogenesis behind osteoporosis is unknown butbelieved to be caused by an imbalance between bone resorption and formation where boneresorption exceeds bone formation. At a high level, lifestyle, personal characteristics, anddrug and disease-related mechanisms all contribute to a person’s risk of developingosteoporosis. Lifestyle risk factors include high-protein diets, long-term calcium deficiency,excessive alcohol or caffeine intake, smoking, and a sedentary lifestyle. Drug and diseaserelated risk factors include the use of aluminum-containing antacids, anticonvulsants, heparinand corticosteroids or Cushing disease. It also includes diseases such as gastrectomy, diabetesmellitus, chronic obstructive lung disease, malignancy, hyperthyroidism,hyperparathyroidism, and rheumatoid arthritis. Overall risk factors include advanced age,being female and white, having small bone structure, being postmenopausal and having afamily history of osteoporosis. Age, gender, genetic predisposition, activity level andnutrition play a role in the development of osteoporosis, although the extent to which isunknown. While exercise may prevent or delay the onset of osteoporosis by increasing peakbone mass density (BMD), poor nutrition and/or age-related decreases in intestinalabsorption of calcium may contribute to the development of osteoporosis. BMD, which is animportant determinant of the risk for osteoporosis development, is determined by geneticfactors, estrogen levels, calcium intake and absorption, exercise, and the maximal amount ofbone in each person (peak bone mass). Race and ethnicity also play a role in BMD and therisk of fractures. Although the incidence of fracture rates are higher among women than men,these difference vary by race and age, such that white and Asian women have higher ratesamong all age groups old than 50 years. On the other hand, black women have the highestBMD values and the lowest fracture rates. Furthermore, body size is another factor affectingrisk of fractures and osteoporosis. Women who are smaller built are at an increased risk ofhip fracture due to a lower hip BMD.

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