Interventions: Patient teaching focuses on factors influencing the development of osteoporosis, interventions to arrest or slow the process, and measures to relieve symptoms. Adequate dietary or supplemental calcium and vitamin D, regular exercises, and modification of lifestyle, if necessary, help to maintain bone mass. Diet, exercise, and physical activity are the primary keys to developing high density bones that are resistant to osteoporosis. It is emphasized that all people continue to need sufficient calcium, vitamin D, sunshine, and exercises to slow the progression of osteoporosis.
Patient teaching related to medication therapy is important. Because gastrointestinal symptoms and abdominal distention are frequent side effects of calcium supplements. Relieving pain. Relief of back pain resulting from a compression fracture may be accomplished by resting in bed in a supine or side-lying position several times a day. The mattress should be firm and nonsagging. Knee flexion increases comfort by relaxing back muscles. Intermittent local heats and back rubs promote muscle relaxation. The nurse instructs the patients to avoid twisting and to move the trunk as a unit.
The nurse encourages good posture and teaches body mechanics. A lumbosacral corset is worn when the patient is out of bed. Improving Bowel Elimination. Constipation is a problem related to immobility and medications. Early institution of a high-fiber diet, increase fluids and the use of prescribed stool softeners help to prevent or minimize constipation. The nurse therefore, monitors patient’s intake, bowel sounds and bowel activity. Preventing Injury. Physical activity is essential to strengthen muscles, improve balance, prevent disuse atrophy and retard progressive bone demineralization. Isometric exercises can strengthen trunk muscles.
The nurse encourages walking, good body mechanics, and good posture. Daily weight- bearing activity, preferably outdoors in the sunshine to enhance the body’s ability to produce vitamin D, is encouraged. Sudden bending, jarring and strenuous lifting are avoided.
References: 1. Bigos, S. et al. (1994, December). Acute low back problems in adults: Clinical practice guidelines- Quick reference guide number 14. (AHCPR Pub. No. 95-0643. ) Rocksville, MD: U. S Department of Health and Human Services, Public Health Servuce, Agency for Health Care Policy and Research. 2. Bullock, B. , & Henze, R. (2000).
Focus on Pathophysiology. Philadelphia: Lippincott Williams & Wilkins. 3. Childs, S. (Ed. ). (1999). The upper extremity: Traumatic injuries and conditions. Pitman, NJ: National Association of Orthopaedic Nurses. 4. Kleerokeper, M. , et al. (1999). The bone and mineral manual. San Diego: Academic Press. 5. Koopman, W. (Ed. ). (2001). Arthritis and allied conditions (14th Ed. ). Philadelphia: Lippincott Williams & Wilkins. 6. Levesque, J. , et al. (1998). A clinical guide to primary bone tumors. Baltimore: Williams & Wilkins. 7. Maher, A. , et al. (2003). Orthopaedic Nursing (3rd Ed. ). Philadelphia: W. B. Saunders.