Controlling Osteoporosis: Clinical Reasoning Cycle Steps and Preventive Measures
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Added on 2022/10/15
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This presentation discusses the clinical reasoning cycle steps and preventive measures for controlling osteoporosis. It covers the goals established, actions taken, and evaluation of the treatment. The preventive measures and medications prescribed are also discussed.
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Clinical Reasoning Cycle step-5: Establish Goals •According to SMART attributes the required goals are defined as follows: •Primary goal is to control the condition of osteoporosis of the patient. Source:(Schubert, Momeyer, & Tornwall ,2019) S (Specific)I want to improve his present condition of osteoporosis and increase the required hormone level which can control the quality of bones. M (Measurable)The pain in lower back and legs has to be reduced to 5/10 and 4/10 respectively (during movement and static condition) within 90 days . A (Achievable)Reducing the level of osteoporosis is possible if the hormone levels will be under control and the supportive medications would be provided. R (Relevant)These interventions are essential as osteoporosis is a measure concern for the patient. Improvement of the condition of osteoporosis can save her from inconveniences regarding pains and fractures. T (Timely)Required time for the intervention is three months.
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Clinical Reasoning Cycle step-6:Take actions •Various actions are taken under consideration for controlling the condition of osteoporosis by; •Controlling hormonal regulation with prescribed medication •Improving bone quality or density •Monitoring the conditions •Include calcium and vitamin D, B12enriched diet •Maintain daily exercise recommended by the physiotherapist.
Clinical Reasoning Cycle step-6:Take actions The preventive actions are included in the following assessments as •Stabilising the lumbar compression fracture •Pain management •Increasing functional independence The preventive measures: •Weekly 70mg Alendronate is prescribed for reducing the risk of lumbar fracture. •Oestelin is provided for the patient to strengthen the muscles and bones. •Nurofen 200 mg will be provided to reduce pain. •Paracetamol ,500 mg has been prescribed .
ClinicalReasoning Cycle step-7 : Evaluation •X-ray reveals compression of lumbar (L2) fracture Alendronate is a bisphosphonate, that is why it is effective for osteoporosis. •Oestelin is prescribed by the doctors for patients with bone problems. The medication is helpful to increase the calcium in the body naturally. •Nurofen and paracetamol are prescribed for reducing pain in the body, so the patient’s condition will be clarified after taking the medicines.
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Clinical Reasoning Cycle step-8: Reflection •Next time I would refer the doctor to emphases on the physical exercise or the physiotherapy from a very early stage of treatment. •This case represents that the patients of older-aged with post- menopause state needs more concern fro hormonal control methods to control the condition regarded osteoporosis. •ADLs and IADLs should be maintained and improved more to increase the mobility of the patient(Smith et al.,2019). •Mental support should be provided more efficiently for patients. Psychological support will motivate the patient and help her or him to improve the condition(Fallahi, Valiee & Chan, 2019).
References Fallahi, A., Valiee, S., & Chan, S. W. C. (2019). Needs of Women with Osteoporosis in Disease Self-Management: A Qualitative Study.Health Scope, (In Press). Foster, B. L., & Hujoel, P. P. (2018). Vitamin D in dentoalveolar and oral health. InVitamin D(pp. 497-519). Academic Press. Granas, A. G., Bakken, M. S., Ruths, S., & Taxis, K. (2018). Deprescribing for frail older people–Learning from the case of Mrs. Hansen.Research in Social and Administrative Pharmacy,14(6), 612-616. Hirsch, C. (2018). In postmenopausal women with osteoporosis, romosozumab followed by alendronate reduced fractures vs alendronate alone.Annals of internal medicine,168(2), JC3-JC3. Ishimoto, Y., Yamada, H., Curtis, E., Cooper, C., Hashizume, H., Minamide, A., ... & Yoshida, M. (2018). Spinal Endoscopy for Delayed- Onset Lumbar Radiculopathy Resulting from Foraminal Stenosis after Osteoporotic Vertebral Fracture: A Case Report of a New Surgical Strategy.Case reports in orthopedics,2018. Miller, P. D., Hattersley, G., Riis, B. J., Williams, G. C., Lau, E., Russo, L. A., ... & Fitzpatrick, L. A. (2016). Effect of abaloparatide vs placebo on new vertebral fractures in postmenopausal women with osteoporosis: a randomized clinical trial.Jama,316(7), 722- 733. Naylor, K. E., Bradburn, M., Paggiosi, M. A., Gossiel, F., Peel, N. F. A., McCloskey, E. V., ... & Eastell, R. (2018). Effects of discontinuing oral bisphosphonate treatments for postmenopausal osteoporosis on bone turnover markers and bone density.Osteoporosis International,29(6), 1407-1417. Schubert, C., Momeyer, M. A., & Tornwall, J. (2019). Nursing Peer Review in an Online Course.Journal of Nursing Education,58(6), 374-374. Smith, M. L., Heeren, T. C., Ranker, L. R., & Fredman, L. (2019). Assessing the Role of Selection Bias in the Protective Relationship Between Caregiving and Mortality: the Caregiver-Study of Osteoporotic Fractures.American journal of epidemiology.