Osteoporosis Screening Discussion Essay Paper
This is a continuation of order ID# 249451.
- (1 page) Based off the one women’s health issue you picked, postyour responses to the following questions.
Osteoporosis – What are your options for primary prevention? How would you educate someone on the treatment?
- Reply to peer’s post: 1 to 2 paragraphs per pear response.
Note: Responses are directed to the peer, they are at a critical level means discussing things such as your opinion of the point mentioned, why you hold that opinion, what you see wrong with the point mentioned, how you see the point consistent/inconsistent with what you have learned so far, implications for the future, consistencies/inconsistencies within the article or reading itself, and so forth. Expand on their explanation and provide an example that supports their explanation or respectfully challenging their explanation and providing an example. Osteoporosis Screening Discussion Essay Paper
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Cite your reference(s) using APA 7 format.
– Responses are supported with at least 2 scholarly source per response
Angelina M’ Post
Osteoporosis
Osteoporosis is defined as low bone mineral density caused by altered bone microstructure, ultimately predisposing patients to low-impact, fragility fractures (Porter & Varacallo, 2022). A fracture related to osteoporosis can lead to a decrease in the quality of life. Risk factors for osteoporosis include increasing age, family history, female gender, white race, low body mass index, use of corticosteroids, early menopause, and prior history of fractures (Porter & Varacallo, 2022). As a nurse practitioner, when performing a history and physical, it is vital to recognize women at high risk for osteoporosis to initiate early screening measures. Osteoporosis Screening Discussion Essay Paper
Osteoporosis Symptoms
Osteoporosis is often called a “silent disease” because there are typically no symptoms until an individual breaks a bone (Akkawi & Zmerly, 2018). One of the patients’ first complaints is loss of height caused by vertebral compression due to fractures (Sozen et al., 2017). Patients might also present with back pain, stooped posture, dowager’s hump, and increased fractures (Sozen et al., 2017).
Osteoporosis Screening
The USPSTF recommends screening for osteoporosis with bone measurements to prevent osteoporotic fractures in women 65 years and older (Curry et al., 2018). The USPSTF also recommends screening with bone measurements to prevent osteoporotic fractures in postmenopausal women younger than 65 at increased risk of osteoporosis (Curry et al., 2018). If a postmenopausal female had a low BMI, smokes, and has excessive alcohol consumption, they would be considered high risk, and early screening would be initiated. There are several tools available to assess osteoporosis risk, including the Fracture Risk Assessment Tool (FRAX) and the Simple Calculated Osteoporosis Risk Estimation (SCORE) (Curry et al., 2018). Osteoporosis Screening Discussion Essay Paper
Diagnostic test
The World Health Organization (WHO) has established that a dual X-ray absorptiometry scan of the central skeleton is the best test for assessing bone mineral density (Porter & Varacallo, 2022). DEXA is used to measure the bone mineral density of the hips and spine. The result of the test is described as a T-score. A T-score between -1 and -2.5 indicated osteopenia, and scores below a negative 2.5 standard deviation reflect a diagnosis of osteoporosis (Porter & Varacallo, 2022). Patients with osteoporosis should also have lab work completed, including renal and thyroid function, calcium level, and 25-hydroxyvitamin D (Porter & Varacallo, 2022). Osteoporosis Screening Discussion Essay Paper
Treatment for Osteoporosis
The primary goal of treatment is to prevent the risk of fractures. It is vital to teach patients and their families about strategies for the prevention of falls. Prevention strategies include fall avoidance by correcting decreased visual acuity, reducing consumption of medication that alters alertness and balance, reducing fall hazards in the home, practicing physical activity to improve muscle strength, adequate dietary intake, and avoiding smoking and excessive alcohol consumption (Akkawi & Zmerly, 2018).
Bisphosphonates are the first line treatment for osteoporosis and include Alendronate and Risedronate. Bisphosphonates are potent inhibitors of bone resorptions and mainly increase the bone mineral density of trabecular bones (Akkawi & Zmerly, 2018). Bisphosphonates also reduce vertebral, nonvertebral, and hip fractures (Akkawi & Zmerly, 2018). A side effect of this medication is mild upper gastrointestinal symptoms such as dysphagia and esophagitis (Akkawi & Zmerly, 2018). When prescribing this class of medication, it is essential to educate the patient to take it with a full glass of water and to avoid laying down for thirty minutes after taking the medication to reduce the occurrence of side effects. Osteoporosis Screening Discussion Essay Paper
Denosumab is another medication that can prevent bone resorption. Denosumab is a RANKL inhibitor, which targets the RANKL, inhibits its ability to bind to RANK, and inhibits osteoclast activation (Porter & Varacallo, 2022). Additional medications include conjugated estrogen-progestin hormone replacement (HRT), estrogen-only replacement (ERT), and selective estrogen receptor modulators (Raloxifene) (Porter & Varacallo, 2022).
By Day 5: Osteoporosis – What are your options for primary prevention? How would you educate someone on the treatment?
Counseling is an integral component of the prevention of osteoporosis. Primary prevention strategies for osteoporosis include lifestyle changes, exercise, intake of calcium and vitamin D, avoiding alcohol, smoking, and excessive intake of salt (Pai, 2017). As a practitioner, I will educate my patient in their 30s and 40s about how smoking, excessive alcohol consumption, and a sedentary lifestyle can increase their risk of developing osteoporosis. It is vital to start education early, giving individuals the time to make changes to decrease their likelihood of developing osteoporosis. Osteoporosis Screening Discussion Essay Paper
If I had a patient starting treatment for osteoporosis, I would explain the medication I prescribe, how it works, and possible side effects. I would educate my patient that bisphosphonates are widely used to prevent and treat osteoporosis and slow the breakdown and removal of bone (Pai, 2017). I will educate them to take the medication in the morning with 8 oz of water at least half-hour before eating, drinking, or taking other medications (Pai, 2017). I would also educate them not to lie down for thirty medications taking the medication to avoid possible side effects, including esophagitis.
Reference
Akkawi, I., & Zmerly, H. (2018). Osteoporosis: Current Concepts. Joints, 6(2), 122–127. https://doi.org/10.1055/s-0038-1660790Links to an external site. Osteoporosis Screening Discussion Essay Paper
Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., … & US Preventive Services Task Force. (2018). Screening for osteoporosis to prevent fractures: US Preventive Services Task Force recommendation statement. Jama, 319(24), 2521-2531.
Pai M. V. (2017). Osteoporosis Prevention and Management. Journal of obstetrics and gynaecology of India, 67(4), 237–242. https://doi.org/10.1007/s13224-017-0994-3
Porter, J., & Varavallo, M. (2022). Osteoporosis. https://www.ncbi.nlm.nih.gov/books/NBK441901/Links to an external site.
Sözen, T., Özışık, L., & Başaran, N. Ç. (2017). An overview and management of osteoporosis. European journal of rheumatology, 4(1), 46–56. https://doi.org/10.5152/eurjrheum.2016.048
Shasta P’ Post
Osteoporosis is a bone disorder resulting in bone mass loss (Matzkin et al., 2019). Due to the loss of bone mass, deterioration of the bone microarchitecture occurs, leading to an increase in fractures (Matzkin et al., 2019). Osteoporosis is a pervasive disorder in postmenopausal women. Postmenopausal women make up two-thirds of the diagnosis of osteoporosis in the United States (Ruiz-Esteves et al., 2022). Primary osteoporosis develops in women due to the drop in estrogen levels. This results in more bone resorption than formation. The following discussion will reflect on the common symptoms, the recommended diagnostic tests, and the common treatments for osteoporosis. The discussion will also answer the options for primary prevention of osteoporosis and treatment education for patients. Osteoporosis Screening Discussion Essay Paper
Unfortunately, osteoporosis is not typically found until a patient suffers a fracture. It is good to ask the patient about a history of fractures, other chronic medical conditions, medications, and surgical history. A bilateral salpingo-oophorectomy is a procedure that would also place the patient at an increased risk of developing osteoporosis. Certain endocrine disorders and smoking history can also put the patient at risk of osteoporosis (Matzkin et al., 2019). Assessing the patient’s menopausal status is needed too to evaluate the risk of osteoporosis.
Although osteoporosis is often asymptomatic until the patient starts having frequent fractures, there are many diagnostic tests to assess for the disorder. The American Association of Endocrinology recommends the assessment of osteoporosis for postmenopausal women aged 50 and older (Hudson, 2022). The gold standard for diagnosing osteoporosis is the dual-energy X-ray absorption (DXA) scan (Hudson, 2022). The DXA scan measures bone mineral density (Hudson, 2022). A computed tomography (CT) scan can also be used for diagnostic testing of osteoporosis (Keaveny et al., 2020). Laboratory testing that can identify osteoporosis is serum calcium and vitamin D levels (Eisenhauer et al., 2019). A drop in these can also indicate a risk of osteoporosis. Osteoporosis Screening Discussion Essay Paper
Fortunately, with the screening to detect osteoporosis, providers can identify osteoporosis early and prescribe the needed supplements or medications to strengthen bone health. Pharmacological treatment options for osteoporosis include calcium and vitamin D supplements, bisphosphonates, denosumab, hormonal replacement treatment, and novel therapies such as romosozumab and Dickkopf-1 inhibitors (Barnsley et al., 2021). For primary prevention, providers can recommend to postmenopausal women the importance of taking a calcium and vitamin D supplement daily to support good bone health. Treatment education would include drug education and dietary intake of calcium. For example, patients should take bisphosphonates on an empty stomach thirty minutes before food or other medications and remain upright for thirty minutes after taking them (Bartl, 2023).
In conclusion, osteoporosis results from various chronic health conditions but is most prevalent in postmenopausal women. Assessment of the at-risk populations, diagnostic testing, recommended preventative strategies, and treatment options are crucial in decreasing the risk of fractures in postmenopausal women. Osteoporosis Screening Discussion Essay Paper
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References
Barnsley, J., Buckland, G., Chan, P. E., Ong, A., Ramos, A. S., Baxter, M., … & Patel, H. P. (2021). Pathophysiology and treatment of osteoporosis: challenges for clinical practice in older people. Aging clinical and experimental research, 33, 759-773.
Bartl, R. (2023). Bisphosphonates (BP) and Denosumab. In Osteoporosis in Clinical Practice (pp. 99-111). Cham: Springer International Publishing. https://link.springer.com/chapter/10.1007/978-3-031-14652-7_10Links to an external site.
Eisenhauer, A., Müller, M., Heuser, A., Kolevica, A., Glüer, C. C., Both, M., & Schrezenmeir, J. (2019). Calcium isotope ratios in blood and urine: a new biomarker for the diagnosis of osteoporosis. Bone reports, 10, 100200.Hudson, T. (2022). Osteoporosis in women: A look at risk factors, risk assessment, bone density testing, and overview of treatments. Townsend Letter, 463–464, 36.
Keaveny, T. M., Clarke, B. L., Cosman, F., Orwoll, E. S., Siris, E. S., Khosla, S., & Bouxsein, M. L. (2020). Biomechanical Computed Tomography analysis (BCT) for clinical assessment of osteoporosis. Osteoporosis International, 31, 1025-1048.
Matzkin, E. G., DeMaio, M., Charles, J. F., & Franklin, C. C. (2019). Diagnosis and treatment of osteoporosis: what orthopaedic surgeons need to know. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 27(20), e902-e912. https://journals.lww.com/jaaos/Fulltext/2019/10150/Diagnosis_and_Treatment_of_Osteoporosis__What.6.aspx?casa_token=dpZ8WyZ-cqEAAAAA:9Y2EnoOKPRWcgtF7ujRdIrpdMK_9aCWRpGt1o0DVABKZyX23f2ZNfgEbpoQgLAIKTlcHgXrL9eUX9PxYd2CZg4jbTwcLinks to an external site.
Ruiz-Esteves, K. N., Teysir, J., Schatoff, D., Yu, E. W., & Burnett-Bowie, S.-A. M. (2022). Disparities in osteoporosis care among postmenopausal women in the United States. Maturitas, 156, 25–29. https://doi.org/10.1016/j.maturitas.2021.10.010Links to an external site. Osteoporosis Screening Discussion Essay Paper