4 Osteoporosis Nursing Care Plans

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.

Here are four (4) nursing care plans for patients with osteoporosis:

  1. Impaired Physical Mobility
  2. Imbalanced Nutrition: Less Than Body Requirements
  3. Risk for Poisoning
  4. Deficient Knowledge
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Impaired Physical Mobility: Limitation in independent, purposeful physical movement of the body or of one or more extremities.

May be related to

  • Bone loss
  • Pain
  • Fracture
  • Inability to bear weight

Possibly evidenced by

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Desired Outcomes

  • 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
Nursing InterventionsRationale
Assess 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 patient has weight-bearing ability.Preserves 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 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 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 stimulating environment (radio, TV, newspapers, personal possessions, pictures, clock, calendar, visits from family and friends).Provides 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 is present.
Provide footboard, wrist splints, trochanter or hand rolls as appropriate.Useful in maintaining functional position of extremities, hands and feet, and preventing complications (contractures, footdrop).
Place in supine position periodically if possible, when traction is used to stabilize lower limb fractures.Reduces risk of flexion contracture of hip.
Instruct and encourage use of trapeze and “post position” for lower limb fractures.Facilitates movement during hygiene or skin care and linen changes; reduces 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 situation, and promotes self-directed wellness.
Provide and assist with mobility by means of wheelchair, walker, crutches, canes as soon as possible. Instruct in 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 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 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 risk of urinary infection, stone formation, and constipation
Provide 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 small bowel, resulting in gas formation and constipation. Therefore, 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 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 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 reality of current condition, prognosis, prolonged immobility, perceived loss of control.
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See Also


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