Which nursing diagnosis is associated with the aging client and risk to maintaining an active state when diagnosed with demineralization of the bone in the older client?

Índice Show

Nursing Care Plans
Recommended Resources

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 nursing care plans and nursing diagnosis for patients with osteoporosis:

Nursing Diagnosis

Impaired Physical Mobility

May be related to

Bone loss
Pain
Fracture
Inability to bear weight

Possibly evidenced by

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 Interventions	Rationale
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 Resources

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.

Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.