Unit 4 Assignment 2:
Disorders Affecting the Immune System
“Cathy is a 67 year old Caucasian woman, who lives alone. She is small framed weighing 126 lbs. Over the past five years she has shrunk from 5’3” to 5’1”. Even though she often requires frequent rest periods she is able to move around without the use of an assistive device. To avoid falling she is extremely cautious of her movements, and understands she can't bend and move in ways that she used to. She often complains of pain and weakness in her joints, and takes Aleve (NSAIDS) to control her pain. She takes daily calcium supplements and maintains a diet high in protein, calcium and vitamin D. Cathy also walks for 30 minutes a day, and while at home she opens the curtains to let in sunlight (photosensitivity). Cathy has Osteoporosis. Her osteoporosis wasn't diagnosed immediately after the first break because broken wrist are not unusual in any age. It took several breaks, in many different areas, over the years before she was diagnosed with osteoporosis. Her doctor preformed a bone mineral density test and x-rays to diagnose her osteoporosis, but by this time her overall function of the skeletal system was compromised. Her doctor explained that her bones are breaking down much faster than they can be built back up. The doctor also explained that her osteoporosis is contributed to menopause, which causes a period of rapid bone mineral loss. Cathy has many of the risk factors associated with Osteoporosis, and is fully aware of her disease. She takes every precaution and makes the appropriate lifestyle changes. She left me with the advice to always pay attention to the signals of your body”. (Anatomy, 2013)
Osteoporosis is an age-related disorder characterized by bone demineralization, decreased bone mass and loss of bone tissue. Bone reabsorption exceeds bone formation and increases susceptibility to fractures. The cause of osteoporosis is unknown, and is commonly referred to as a “silent disease” because it develops without symptoms. Advanced stages of Osteoporosis cause the normal curvature of the spine to change, causing a loss of as much as three to six inches in height. A loss in height often forms the dowagers hump in the upper thoracic vertebrae or kyphosis of the dorsal spine. Osteoporosis can also cause abdominal distention, associated constipation, joint and back pain that radiates around the trunk, and multiple fractures occurring mainly in the hip, vertebral bodies and joints. Postmenopausal women are at highest risk because of the decreased levels of estrogen. Older adults are also at risk, many fractures occur as a result of osteoporosis and often occur prior to the client's falling, rather than as a result of a fall. Other risk factors include a hereditary deposition such as with Caucasian or Asian women, being small thin framed, prolonged immobility, sedentary lifestyle, low calcium intake, increased caffeine intake, and a history of smoking and alcohol intake. Patient teaching should include; a daily weight bearing activity to promote bone formation and avoiding high impact activities. Patients should also maintain active and passive ROM several times a day, proper body mechanics, as well as changing from positions slowly. Eating a diet high in calcium, vitamin D and protein and discouraging alcohol and caffeine intake is also important. Nursing interventions should include; creating a hazard free environment, keeping bed in low position, encourage nonskid slippers when out of bed, provide adequate lighting, and discourage use of throw rugs. Treatment measures for women include hormone replacement therapy (HRT) to reduce bone loss in the post-menopausal women. Remember if using hormone replacement therapy make sure the benefits outweigh the risk.