NUR 2356 EXAM 1 PRACTICE QUESTIONS; Module 05 Assignment – Designing a Care Map

NUR 2356 EXAM 1 PRACTICE QUESTIONS; Module 05 Assignment – Designing a Care Map. Osteoporosis is a metabolic bone disease. It results from an imbalance between osteoclastic bone resorption and osteoblastic bone formation. This imbalance causes bones to become weak and fragile, thus increasing the risk for fractures (Föger-Samwald, et al., 2020). Clinical manifestations of osteoporosis include osteopenia, bone pain or tenderness, cervical and lumbar pain, kyphosis, and height reduction (Story, 2020). Risk Factors: Age, Menopause, EuroCaucasian or Asian ethnicity, low body weight, chronic low calcium/vitamin D, smoking, alcohol, chronic steroid use, poor nutrition, and lack of physical activity (Workman, 2020). Nursing Diagnosis: Impaired physical mobility r/t pain and bone loss AEB 6/10 upper back pain and a bone density T-score of -2.7. Nursing Diagnosis: Deficient knowledge r/t disease process and SMART Goal: Patient will improve physical mobility r/t reduced pain & further bone loss prevention AEB 3/10 pain and improved Tscore of -2.5 in 6 months. SMART Goal: The patient will demonstrate 1. Perform a pain assessment and provide nonpharmacologic pain management strategies. A pain assessment is crucial for determining the patient’s level and quality of pain, the factors affecting it, and its location. Once the assessment has been completed, the patient should be educated on non-pharmalogical interventions such as physical therapy, meditation, massage, and TENs. These therapies can be used to manage the patient’s pain and reduce it to a 3/10. 2. Educate patient on how to take their new medication of Fosamax weekly. Fosamax (alendronate sodium) is a bisphosphonate therapy Common Labwork/Diagnostics: Xray: show bone density, alignment, swelling, and intactness. DEXA: X-ray absorptiometry used to assess bone mineral density. CT-base Absorptiometry: measures the volume of bone density and strength Serum Calcium & Vitamin D3 Bone Turnover Markers (Osteocalcin & bonespecific alkaline phosphatase) Assessment Data (consider subjective, objective, and heath history): Subjective: The patient states she has sharp, knifelike pain in her upper back and rates it 6/10. She states the pain started 3 weeks ago and has not changed since. She has smoke a pack of cigarettes per day for the last 25 years. She states that she knows she should eat better and exercise, but she doesn’t have the treatment AEB patient request for education. Nursing Diagnosis: Risk for injury AEB T7 collapsed vertebrae and bone density changes seen on xray. understanding of her disease state, need for medications, and necessary lifestyle modifications using the teach-back method in 1 hour. SMART Goal: The patient will remain free of injury for the next 6 months. that needs to be taken a particular way in order to reduce the chance of side effects and improve the effectiveness of the medication. It is crucial that the patient understands the medication should be taken first thing in the morning, with 8oz of plain water and that they must remain upright for at least 30 minutes after ingestion (American College of Rheumatology, 2019). 1. Educate patient on the pathology of her condition, medication information, and modifiable risk factors. In order to improve the patient’s knowledge of their condition it is important to educate them on the underlying causes of it and the disease pathophysiology. As there are many modifiable risk factors, it is important to identify them with the patient and formulate strategies to modify them. 2. Provide educate on