Osteoporosis is a metabolic bone disorder in which the rate of bone resorption accelerates while the rate of bone formation slows down, causing a loss of bone mass. Bones affected by this disease lose calcium and phosphate salts and thus become porous, brittle, and abnormally vulnerable to fractures. Osteoporosis may be primary or secondary to an underlying disease. Primary osteoporosis is commonly called postmenopausal osteoporosis because it typically develops in postmenopausal women.
Nursing Care Plans
Medical management of osteoporosis aims at slowing down or preventing further bone loss, controlling pain and avoiding additional fractures. A nurse‘s care plan should focus on the patient’s fragility, stressing careful positioning, ambulation, and prescribed exercises.
- Impaired Physical Mobility
- Imbalanced Nutrition: Less Than Body Requirements
- Risk for Poisoning
- Deficient Knowledge
Impaired Physical Mobility
May be related to
- Bone loss
- Inability to bear weight
Possibly evidenced by
- Spontaneous fracture
- Patient will maintain functional mobility as long as possible within limitations of disease process.
- Patient will have a few, if any, complications related to immobility as disease condition progresses
|Assess the patient’s functional ability for mobility and note changes.||Identifies problems and helps to establish a plan of care.|
|Provide range of motion exercises every shift. Encourage active range of motion exercises.||Helps to prevent joint contractures and muscle atrophy.|
|Reposition patient every 2 hours and prn.||Turning at regular intervals prevents skin breakdown from pressure injury.|
|Apply trochanter rolls and/or pillows to maintain joint alignment.||Prevents musculoskeletal deformities.|
|Assist patient with walking if at all possible, utilizing sufficient help. A one or two-person pivot transfer utilizing a transfer belt can be used if the patient has a weight-bearing ability.||Preserves the patient’s muscle tone and helps prevent complications of immobility.|
|Use mechanical lift for patients who cannot bear weight, and help them out of bed at least daily.||Provides a change of scenery, movement, and encourages participation in activities.|
|Avoid restraints as possible.||Inactivity created by the use of restraints may increase muscle weakness and poor balance.|
|Instruct family regarding ROM exercises, methods of transferring patients from bed to wheelchair, and turning at routine intervals.||Prevents complications of immobility and knowledge assists family members to be better prepared for home care.|
|Assess the degree of immobility produced by injury or treatment and note patient’s perception of immobility.||Patient may be restricted by self-view or self-perception out of proportion with actual physical limitations, requiring information or interventions to promote progress toward wellness.|
|Encourage participation in diversional or recreational activities. Maintain a stimulating environment (radio, TV, newspapers, personal possessions, pictures, clock, calendar, visits from family and friends).||Provides an opportunity for release of energy, refocuses attention, enhances patient’s sense of self-control and self-worth, and aids in reducing social isolation.|
|Instruct patient or assist with active and passive ROM exercises of affected and unaffected extremities.||Increases blood flow to muscles and bone to improve muscle tone, maintain joint mobility; prevent contractures or atrophy and calcium resorption from disuse|
|Encourage use of isometric exercises starting with the unaffected limb.||Isometrics contract muscles without bending joints or moving limbs and help maintain muscle strength and mass. Note: These exercises are contraindicated while acute bleeding and edema are present.|
|Provide footboard, wrist splints, trochanter or hand rolls as appropriate.||Useful in maintaining a functional position of extremities, hands, and feet, and preventing complications (contractures, foot drop).|
|Place in supine position periodically if possible, when traction is used to stabilize lower limb fractures.||Reduces risk of flexion contracture of the hip.|
|Instruct and encourage the use of trapeze and “post position” for lower limb fractures.||Facilitates movement during hygiene or skin care and linen changes; reduces the discomfort of remaining flat in bed. “Post position” involves placing the uninjured foot flat on the bed with the knee bent while grasping the trapeze and lifting the body off the bed.|
|Assist with self-care activities (bathing, shaving).||Improves muscle strength and circulation, enhances patient control in the situation, and promotes self-directed wellness.|
|Provide and assist with mobility by means of wheelchair, walker, crutches, canes as soon as possible. Instruct in the safe use of mobility aids.||Early mobility reduces complications of bed rest (phlebitis) and promotes healing and normalization of organ function. Learning the correct way to use aids is important to maintain optimal mobility and patient safety.|
|Monitor blood pressure (BP) with the resumption of activity. Note reports of dizziness.||Postural hypotension is a common problem following prolonged bed rest and may require specific interventions (tilt table with gradual elevation to upright position).|
|Reposition periodically and encourage coughing and deep-breathing exercises.||Prevents or reduces the incidence of skin and respiratory complications (decubitus, atelectasis, pneumonia).|
|Auscultate bowel sounds. Monitor elimination habits and provide for regular bowel routine. Place on bedside commode, if feasible, or use fracture pan. Provide privacy.||Bed rest, use of analgesics, and changes in dietary habits can slow peristalsis and produce constipation. Nursing measures that facilitate elimination may prevent or limit complications. Fracture pan limits flexion of hips and lessens pressure on lumbar region and lower extremity cast.|
|Encourage increased fluid intake to 2000–3000 mL per day (within cardiac tolerance), including acid or ash juices.||Keeps the body well hydrated, decreasing the risk of urinary infection, stone formation, and constipation|
|Provide a diet high in proteins, carbohydrates, vitamins, and minerals, limiting protein content until after first bowel movement.||In the presence of musculoskeletal injuries, nutrients required for healing are rapidly depleted, often resulting in a weight loss of as much as 20 to 30 lb during skeletal traction. This can have a profound effect on muscle mass, tone, and strength. Note: Protein foods increase contents in the small bowel, resulting in gas formation and constipation. Therefore, the gastrointestinal (GI) function should be fully restored before protein foods are increased.|
|Increase the amount of roughage or fiber in the diet. Limit gas-forming foods.||Adding bulk to stool helps prevent constipation. Gas-forming foods may cause abdominal distension, especially in the presence of decreased intestinal motility.|
|Consult with physical, occupational therapist or rehabilitation specialist.||Useful in creating individualized activity and exercise program. Patient may require long-term assistance with movement, strengthening, and weight-bearing activities, as well as the use of adjuncts (walkers, crutches, canes); elevated toilet seats; pickup sticks or reachers; special eating utensils.|
|Initiate bowel program (stool softeners, enemas, laxatives) as indicated.||Done to promote regular bowel evacuation.|
|Refer to psychiatric clinical nurse specialist or therapist as indicated.||Patient or SO may require more intensive treatment to deal with the reality of current condition, prognosis, prolonged immobility, perceived loss of control.|
Recommended nursing diagnosis and nursing care plan books and resources.
NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses as reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.
Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of it’s evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions show how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.
Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!
All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans for musculoskeletal disorders and conditions:
- Amputation | 4 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Fracture | 11 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Laminectomy (Disc Surgery) | 8 Care Plans
- Osteoarthritis | 4 Care Plans
- Osteoporosis | 4 Care Plans
- Rheumatoid Arthritis | 6 Care Plans
- Scoliosis | 4 Care Plans
- Spinal Cord Injury | 12 Care Plans
- Total Joint (Knee, Hip) Replacement | 5 Care Plans