Care of client with problems in Coordination

• a loss of bone density, occurs principally in older adults and affects more women than men

  Osteoporosis
• Site at least 5 Etiology of Osteoporosis

  Low calcium intake

  Long period of immobility

  Prolonged use of corticosteroids

  Hyperthyroidism/ Hyperparathyroidism

  excessive caffeine intake

  GI Absorption Problems

  Renal Failure

  Alcoholism

  Breast Cancer
• What are the clinical manifestation of Osteoporosis?

  
  

  • lumbosacral pain, thoracic back pain, or both- The bone pain or tenderness results from tiny compression fractures in the vertebrae.
  • Loss of height is known as progressive kyphosis
  • Radiographic examination of the bones shows bone loss once it is 25% or more.
  • Bone deformities Pathologic fracture
  • Other disorders such as multiple myeloma, hyperparathyroidism, or metastatic bone lesions
• Gout is A painful metabolic disorder involving an inflammatory reaction in the joints, usually affects the feet (especially the great toe), hands, elbows, ankles, and  knees.
• Osteomyelitis - is an infection of the bone.š-  Inflammation of and pressure on the tissue, and formation of new bone around devitalized bone  take osteomyelitis a difficult and challenging condition to treat.
• What is used to alleviate bone pain in osteoporosis?

  Analgesics
• Drug of choice to inhibit bone resorption

  Risedronate and Alendronate Sodium
• Calcitonin inhibits bone reabsorption and slows bone loss.
• Selective Estrogen Receptor Modifier (SERM) preserves BMD and thus reduce the risk for osteoporosis.
• It is used to treat osteoporosis in people who are at high risk of fractures.

  Teriparatide
• Tamoxifen (Nolvadex) is used primarily by women with breast cancer or with a high risk of developing breast cancer;
• Nurse especially advises women to drink three glasses of milk daily or eat other dairy products to acquire approximately 1000 to 1500 mg of calcium; Those who smoke cigarettes may require more. Orange

  juice fortified with calcium is a nutritious alternative.
• What are the diagnostic test usually given to diagnose osteoporosis

  CT Scan of the Bone

  Serum Calcium Test

  Vitamin D levels

  Bone mineral densitometry
• is the most common form of arthritis. It also is knownas the ‘‘wear and tear’’ disease and typically affects the weight-bearing joints. It is characterized by a slow and steady progression of destructive changes in weight-bearing joints and those that are repeatedly used for work.

  Osteoarthritis
• Etiology of osteoarthritis:

  1.A lifetime of repeated trauma

  2. Increasing age, previous joint injury, obesity, congenital and developmental disorders (such as Legg-Calve-Perthes disease),

  3. Hereditary factors,

  4. Decreased bone density
• Newer pharmacologic approaches in osteoarthritis include glucosamine and chondroitin

  •These medications theoretically increase tissue function and interfere with the breakdown of cartilage.

  •

  The intra-articulation injection of hyaluronic acid, referred to as viscosupplementation, theoretically improves

  cartilage function and interferes with its breakdown
• In gout, Tophi may be palpated around the fingers, great toes, or earlobes, particularly if the client has chronic and severe hyperuricemia
• Clinical Manifestation of gout:

  1.Sudden onset of acute pain and tenderness in one joint.

  2.The skin turns red

  3.The joint swells so that it is warm and hypersensitive to touch.

  4.Fever may be present.