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Metabolic Diseases of the Bone

Metabolic Diseases of the Bone. Osteoporosis Osteomalacia Paget’s Gout Bone Tumors. Osteoporosis. Characteristics Decrease in bone mass Bone Fracture Women. Osteoporosis. Predisposing Factors Family history Intake of caffeine, alcohol, sodium, protein, some medications Inactivity

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Metabolic Diseases of the Bone

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  1. Metabolic Diseases of the Bone • Osteoporosis • Osteomalacia • Paget’s • Gout • Bone Tumors

  2. Osteoporosis • Characteristics • Decrease in bone mass • Bone Fracture • Women Osteoporosis

  3. Predisposing Factors Family history Intake of caffeine, alcohol, sodium, protein, some medications Inactivity Diseases including hyperthyroidism, diabetes Assessment Back pain, loss of height, Dowagers hump Diagnosis: normal lab studies; decreased bone density Prevention: Calcium to 1000 mg/day; avoid alcohol; calcitonin, Fosamax, Actonel Osteoporosis Osteoporosis treat, prevention

  4. Osteomalacia • Characteristics • Vitamin D Deficiency, like rickets in children • Predisposing Factors • Lack of UV light • GI malabsorption • Kidney disease • Assessment • Skeletal pain • Bowing of legs, kyphosis, Osteomalacia help

  5. Osteomalacia • Diagnosis • Decreased serum calcium • X-ray show bone demineralization • Increased serum alkaline phosphatase • Increased urinary hydroxyproline • WHY? • Treatment • Increase Vit D , normal diet, UV , exercise

  6. Paget’s Disease • Characteristics • Bone deformities due to abnormal regeneration and reabsorption of bone • Affects pelvis, lone bones, spine, cranium • Predisposing factors • White male over 50 • Assessment • Small hat syndrome, pathologic fractures, bone pain • May lead to osteosarcoma, chondrosarcoma Paget’s disease help

  7. Paget’s Disease • Diagnosis • Increased serum alkaline phosphatase • X-ray shows thickened bone, curved, abnormal structure • Nursing diagnosis • Treatment • Supportive • Calcitonin, EHDP, Mithramycin • Exercises

  8. What nursing problems can you identify from this slide?

  9. Gout • Caused by disturbed uric acid metabolism • Urate salts deposited in articular, periarticular and subcutaneous tissue • Primary result of genetic defect purine metabolism • Secondary due to increased cell turnover • ? Who gets secondary gout? Gout help

  10. Manifestations Swollen, tender red joints Diagnostic Tests Nursing Diagnosis Interventions Acute: alleviate pain, inflammation Bedrest Medications including ASA, NSAID, Colchicine IV or orally (GI symptoms) Assessment Gouty Arthritis

  11. Manifestations Swollen, tender red joints Diagnostic Tests Nursing Disgnosis Interventions Acute:alleviate pain, inflammation Bedrest Medications including ASA, NSAID, Colchicine IV or orally (GI symptoms) Assessment Gouty Arthritis

  12. Uricosuric Agents Probenecid (ASA an antagonist); inhibits resportion of uric acid thus increases excretion of uric acid Sulfinprazone (anturan) to block resorption uric acid Need high fluid intake, alkaline urine Xanthine-oxidase inhibitors decrease uric acid production Allopurinal (zyloprim); may cause agranucytosis Need high fluid intake, and alkaline urine Management of Gout

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