NUR 170 WEEK 8 CASE STUDY 41- OSTEOPOROSIS LATEST
UPDATE
Case Study 41 - Osteoporosis
Difficulty: Beginning
Setting: Outpatient clinic
Index Words: osteoporosis, risk factors, medications, patient teaching
Giddens Concepts: Coping, Nutrition, Patient Teaching
HESI Concepts: Assessment, Nutrition, Patient Teaching, Stress & Coping
Name Class/Group Date
Scenario
M.S., a 74-year-old woman, comes to your clinic for a complete physical examination.
She has not been to a provider for 11 years because “I don’t like doctors.” Her only
complaint today is “pain in my upper back.” She describes the pain as sharp and
knifelike. The pain began approximately 3 weeks ago when she was getting out of bed
in the morning and hasn’t changed at all. M.S. rates her pain as 6 on a 0- to 10-point
pain scale and says the pain decreases to 3 or 4 after taking “a couple of ibuprofen.”
She denies recent falls or trauma.
M.S. admits she needs to quit smoking and start exercising but states, “I don’t have the
energy to exercise and, besides, I’ve always been thin.” She has smoked one to two
packs of cigarettes per day since she was 17 years old. Her last blood work was 11
years ago, and she cannot remember the results. She went through menopause at the
age of 47 and has never taken hormone replacement therapy. The physical examination
findings are unremarkable other than moderate tenderness to deep palpation over the
spinous process at T7. There are no masses or tenderness to the tissue surrounding the
tender spot. No visible masses, skin changes, or erythema are noted. Her neurologic
findings are intact, and no muscle wasting is noted.
1. An x-ray examination of the thoracic spine reveals a collapsed vertebra at T7 and
bone density changes in the spine. What could this result indicate? Osteoporosis
2. The physician suspects osteoporosis. List seven risk factors associated with
osteoporosis. Female, white or Asian, lack of adequate exercise, low body
weight, postmenopausal, advanced age, cigarette smoking
3. Place a star or asterisk next to those risk factors specific to M.S. M.S. meets all
seven of the above risk factors
CASE STUDY PROGRESS
M.S. has never had an osteoporosis screening. She confides that her mother and
grandmother were diagnosed with osteoporosis when they were in their early 50s.
4. What diagnostic test is most commonly used to diagnose osteoporosis? DXA scan is
used to measure spine and hip bone density
5. M.S.’s diagnostic test revealed a bone density T-score of –2.7. How will this be
interpreted? Anything lower than a -2.5 indicates osteoporosis
6. M.S. receives a prescription for alendronate (Fosamax) 70 mg/wk. Which instructions
are appropriate as you provide patient teaching to M.S. about this drug? Select all that
apply.
a. You can eat your breakfast along with this medication.”
UPDATE
Case Study 41 - Osteoporosis
Difficulty: Beginning
Setting: Outpatient clinic
Index Words: osteoporosis, risk factors, medications, patient teaching
Giddens Concepts: Coping, Nutrition, Patient Teaching
HESI Concepts: Assessment, Nutrition, Patient Teaching, Stress & Coping
Name Class/Group Date
Scenario
M.S., a 74-year-old woman, comes to your clinic for a complete physical examination.
She has not been to a provider for 11 years because “I don’t like doctors.” Her only
complaint today is “pain in my upper back.” She describes the pain as sharp and
knifelike. The pain began approximately 3 weeks ago when she was getting out of bed
in the morning and hasn’t changed at all. M.S. rates her pain as 6 on a 0- to 10-point
pain scale and says the pain decreases to 3 or 4 after taking “a couple of ibuprofen.”
She denies recent falls or trauma.
M.S. admits she needs to quit smoking and start exercising but states, “I don’t have the
energy to exercise and, besides, I’ve always been thin.” She has smoked one to two
packs of cigarettes per day since she was 17 years old. Her last blood work was 11
years ago, and she cannot remember the results. She went through menopause at the
age of 47 and has never taken hormone replacement therapy. The physical examination
findings are unremarkable other than moderate tenderness to deep palpation over the
spinous process at T7. There are no masses or tenderness to the tissue surrounding the
tender spot. No visible masses, skin changes, or erythema are noted. Her neurologic
findings are intact, and no muscle wasting is noted.
1. An x-ray examination of the thoracic spine reveals a collapsed vertebra at T7 and
bone density changes in the spine. What could this result indicate? Osteoporosis
2. The physician suspects osteoporosis. List seven risk factors associated with
osteoporosis. Female, white or Asian, lack of adequate exercise, low body
weight, postmenopausal, advanced age, cigarette smoking
3. Place a star or asterisk next to those risk factors specific to M.S. M.S. meets all
seven of the above risk factors
CASE STUDY PROGRESS
M.S. has never had an osteoporosis screening. She confides that her mother and
grandmother were diagnosed with osteoporosis when they were in their early 50s.
4. What diagnostic test is most commonly used to diagnose osteoporosis? DXA scan is
used to measure spine and hip bone density
5. M.S.’s diagnostic test revealed a bone density T-score of –2.7. How will this be
interpreted? Anything lower than a -2.5 indicates osteoporosis
6. M.S. receives a prescription for alendronate (Fosamax) 70 mg/wk. Which instructions
are appropriate as you provide patient teaching to M.S. about this drug? Select all that
apply.
a. You can eat your breakfast along with this medication.”
