Osteoporosis Pathophysiology and Risk Factors
Pathophysiology and risk factors of osteoporosis, bone fracture and bone healing (approx. 500 words):
Osteoporosis is a metabolic condition where bones become so weak and brittle that they undergo a fracture even upon receiving mild stress. In osteoporosis, the independence level of the patient is negatively affected and they are rendered incapable of performing everyday activities. The main reason behind osteoporosis development is poor bone health which may develop due to a number of reasons. It usually results when bone mass and bone mineral density reduced which impacts the structure and strength of bones, thereby making the bones more susceptible to fractures (Akkawi & Zmerly, 2018).
Osteoporosis pathophysiology is complex and involves numerous factors. It results due to extended imbalanced in bone remodelling. On a cellular level, osteoporosis develops when osteoclastic bone resorption is not compensated by osteoclastic bone formation. In most of the individuals, peak of bone mass is observed during the third decade i.e., between 30-40 years of age which is accompanied by resorption of bone which does not excess bone formation. As a result, the bones do not reach the desired peak bone mass and become weak and fragile which leads to osteoporosis making the bones susceptible to fractures (Leder & Wein, 2020).
Fig: Osteoporosis impact on bone
(Source: spineuniverse.com)
Fracture of bone and the process of healing is dependent on the synergy between the cellular, molecular, and biochemical factors. On the basis of different stages, a fractured hematoma acts as the initial point for the inflammatory process which is vital for triggering the healing process. The factors that are needed for repairment of fractured include activating the mesenchymal stem cells, triggering release of growth and regulatory factors (Clynes et al., 2020). Appropriate blood supply, adequate stability, and proper contact between the bone fragments help in determining the efficacy of the process of fracture healing. In osteoporosis however, the bone quality is impacted in a negative manner which increases the probability of developing a complicated fracture healing. The qualitative and quantitative alterations in osteoporosis at the cellular level explains how bones deteriorate at a rapid rate and also explains bone tissue deterioration which adversely affects the bone tissue healing ability (Calcei & Rodeo, 2019).
The risk factors of osteoporosis may be modifiable or non- modifiable. Modifiable risk factors include obesity, smoking, poor lifestyle habits, increased alcohol intake. Non- modifiable risk factors include gender, age, and family history. In the given case study of Mrs Yvonne, the risk factors evident for her include her age, gender, and her habit of smoking. Age is a risk factor of osteoporosis because with increasing age the rate of bone formation does not compensate the rate of bone breakdown, thereby making the bones weak and brittle and promotes osteoporosis development. Mrs Yvonne was 60 which is why she was at an increased risk of osteoporosis. Being a post-menopausal woman, her reduced oestrogen levels also increased her susceptibility to osteoporosis. She was also a smoker which possibly promoted imbalance in bone turnover and reduced her bone mass while increasing her risk of developing osteoporosis and also made her more prone to fractures (Ferrari & Roux, 2019).
Bone Fracture and Healing Process
Osteoporosis is a metabolic bone disorder which affects millions of elderly people. This condition not only results in development of many physical challenges but also causes negative psychosocial and financial consequences which adversely impacts the overall well- being and health of the patient. Identification of health promotion strategies, ambulatory care, and home care is therefore essential so that Mrs Yvonne’s health outcomes can improve and her well being can be maintained (Chan, Mohamed, Ima-Nirwana & Chin, 2018).
It is firstly essential to ensure that Mrs Yvonne is educated about her condition and associated risk factors. This will help her in making healthy lifestyle decisions in life and will also encourage her to make changes in her daily routine so that she can achiever her set goals. Patient education is a vital aspect of the health promotion plan and it is of increased importance since majority of the individuals with osteoporosis are unaware of the severe and adverse consequences related to this condition. Early diagnosis and management can lower the rate of mortality. It is therefore essential to educate Mrs Yvonne about the changes that she must add to her daily routine and strategies on how she can better adhere to her medication regime which will improve her outcomes (Cornelissen et al., 2020). The lifestyle modification that Mrs Yvonne needs to make includes ceasing smoking. Smoking promotes development of osteoporosis. Mrs Yvonne should therefore quit smoking. She can do so by undertaking NRT (nicotine replacement therapy) which has proved to be an effective therapy for controlling the desire of smoking. Mrs Yvonne can also take the help of other options such as sprays, sublingual tablets, transdermal patches, and inhalers which can enable her to incorporate this change (Nguyen, 2018). She must also be informed of the beneficial effects of a healthy diet. Mrs Yvonne must consume a diet that is rich in calcium such as dairy products like yogurt, milk, cheese, fishes such as salmon and sardines, fatty fishes such as mackerel, eggs, liver, fresh fruits, vegetables, and grains. Consuming such a healthy diet can promote the health of her bones by filling in the gas and by enhancing her calcium levels which can promote formation of bone.
Fig: Management of osteoporosis
(Source: Drugs.com)
Ambulatory care implies to nursing care that is provided to patients who are not in hospitals and who receive outpatient care. Ambulatory care for Mrs Yvonne includes recommending and encouraging her to increase consumption of healthy food items such as calcium- rich food and legumes and beans which contain high levels of phytates, vitamin-A containing foods, and foods rich in salt content. She must also be informed to increase her milk consumption, intake of leafy green vegetables, almonds, cheese, fish oils, fortified milk, and bread which contain increased levels of vitamin D (Hejazi et al., 2020). Mrs Yvonne must also be directed to increased her daily liquid intake. She must limit caffeine and alcohol consumption as it can reduce the mineral density of her bone. And cause further weakening of her bones. Mrs Yvonne must also be encouraged to exercise regularly. Performing weight bearing exercises for about 30 minutes for 3 days in a week can improve Yvonne’s psychological status. Encouraging her to perform in physical therapy can also improve Mrs Yvonne’s movement and her overall strength (Galli, Weiss, Beck & Scerpella, 2021).
Risk Factors of Osteoporosis
Home care for osteoporosis is aimed at promoting such exercises and actions that can be easily performed at home. This includes gardening, walking, climbing, or performing exercises that are of low- intensity. These exercises can impact Mrs Yvonne in a positive manner by delaying mineral loss and improving strength of her legs, hips, and her lower spine. These interventions will also ensure that Mrs Yvonne’s circulatory system is improved and will therefore improve her overall health. Mrs Yvonne also suffered a fall (Varahra et al., 2018). Therefore, home care that she must receive is provision of wheelchairs or walking sticks which can help her in mobilizing and will also ensure that potential future falls are prevented. It will decrease the strain on her affected part and also ensure that the process of healing is promoted. At home, her family members and carers can ensure maintenance of a safe environment. This can be achieved by ensuring that appropriate lighting is present, materials that slip are removed, and by maintaining a soothing environment which will calm Mrs Yvonne and promote her health (Statham & Aspray, 2021).
In the given situation, age and gender are two social justice factors of Mrs Yvonne which can adversely impact her health. Mrs Yvonne is aged 60 years, and she is not financially stable. Osteoporosis has lowered her productivity and thereby impacted her financial status. Prior to her retirement, she has only limited time contributes to increased stress. She also separated from her spouse which can be another reason for increased stress that she faces. It is therefore necessary that some emotional as well as financial adequate support is offered to Yvonne (Nahm, 2020). Some referrals to governmental as well as non- governmental organizations need to be made to Yvonne from where she can take help. Recommending Yvonne to enrol in support groups can also help her by improving her knowledge of the condition and ways on how she can tackle the emotional stress due to osteoporosis. Being a part of support groups can allow Mrs Yvonne to gain insights into the life of people with osteoporosis and she can also engage with patients with similar condition which can help her in coping with the emotional, psychological, as well as the physical impacts of osteoporosis (FARCA? et al., 2019).
The Code of Ethics for Nurses in Australia has been established for the nursing professionals in Australia and it highlights the commitment of nurses to promote, protect, uphold, and respect the fundamental rights of patents. The Code of Ethics also requires that nursing professionals must delver nursing care that is of supreme quality, be respectful to others, and be kind, value diversity, make well-informed decisions, and ensure that a culture of safety is promoted. Nurses are also required to value and ethically manage information, while promote safety and well- being of their patients at all costs. The Code of Ethics is built upon the professional standards, regulations, and laws which govern the nursing practice (Nursing and Midwifery Board of Australia, 2021).
Management of Osteoporosis
It is required by the nurses, according to the Code of Ethics, to offer such care to Mrs Yvonne that is ethically right, and which is in line with her customs, opinions, and her religious beliefs. The nurses must ensure that while offering care, Mrs Yvonne and her decisions are respected and acknowledged. Patient confidentiality and privacy must be maintained at all times, the nursing professionals must advocate for social services, economic, and health care services. Lastly, the nursing professionals must also show compassion, care, and trustworthiness while offering care to Mrs Yvonne (Boozaripour, Abbaszadeh, Shahriari & Borhani, 2018).
To conclude, Osteoporosis is a metabolic bone disorder where bone remodelling is imbalanced and bone resorption is not compensated for equivalent amounts of bone formation. Bones therefore become too weak and brittle. The leaflet discussed Mrs Yvonne’s case study who was diagnosed with osteoporosis. This leaflet identified some risk factors of osteoporosis which include age, gender, lifestyle such as smoking. The health promotion, ambulatory care, and home care strategies have also been discussed which include increased consumption of vitamin D and calcium, and fruits and vegetables which can promote formation of bones and ensure that the imbalance is corrected. The leaflet also mentioned use of exercises which can strengthen Mrs Yvonne’s bones and prevent falls and fractures. Stopping smoking is another intervention that Mrs Yvonne must adopt which will improve her bone health. The leaflet next discussed social justice factors where strategies of coping with emotional stress and the financial burden of osteoporosis were discussed. Lastly, the leaflet identified the role of nursing professionals in offering care which includes care that is ethically correct, which upholds the fundamental rights, and where Mrs Yvonne’s decisions are acknowledged and respected.
Reference list
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