Health Promotion and Maintenance Q 122
The nurse knows that a 60-year-old female client’s susceptibility to osteoporosis is most likely related to:
A. Lack of exercise
B. Hormonal disturbances
C. Lack of calcium
D. Genetic predisposition
Correct Answer: B. Hormonal disturbances
After menopause, women lack hormones necessary to absorb and utilize calcium. Primary osteoporosis is related to the aging process in conjunction with decreasing sex hormones. The bones have deterioration in microarchitecture leading to loss of bone mineral density and increased risk of a fracture. Osteoporosis is defined as low bone mineral density caused by altered bone microstructure ultimately predisposing patients to low-impact, fragility fractures. Osteoporotic fractures lead to a significant decrease in quality of life, with increased morbidity, mortality, and disability.
Option A: Risk factors for osteoporosis include increasing age, body weight less than 128 pounds, smoking, family history of osteoporosis, white or Asian race, early menopause, low levels of physical activity and a personal history of a fracture from a ground-level fall or minor trauma after the age of forty. Patients afflicted with conditions affecting overall mobility level, such as spinal cord injuries (SCI), can experience rapid deterioration of bone mineral density levels within the first 2 weeks following these debilitating injuries.
Option C: Taking calcium supplements can help to prevent osteoporosis but are not causes. Osteoporosis is caused by an imbalance of bone resorption and bone remodeling leading to decreased skeletal mass. In most individuals, bone mass peaks in the third decade, after which bone resorption exceeds bone formation. Failure to reach a normal peak bone mass or acceleration of bone loss can lead to osteoporosis.
Option D: Body types that frequently experience osteoporosis are thin Caucasian females, but they are not most likely related to osteoporosis. In white men, the risk of an osteoporotic fracture is 20%, but the one-year mortality in men who have a hip fracture is twice that of women. Black males and females have less osteoporosis than their white counterparts, but those diagnosed with osteoporosis have similar fracture risks. The aging of the American population is expected to triple the number of osteoporotic fractures.