Clinical Placement Preparation Report for NUR1299, Semester 2, 2019

This report, prepared for the NUR1299 Clinical Placement Preparation assignment, explores the health issues of the elderly, specifically osteoporosis, within an aged care hospital setting. The report delves into clinical preparation, discussing the causes, symptoms, and treatment options for osteoporosis, including medications and palliative care approaches. It also highlights the role of registered nurses in providing holistic care, emphasizing empathy, communication, and patient consent. The report includes a personal reflection on the author's experience in aged care, emphasizing the importance of empathy and the increasing role of nurses in end-of-life care. The author references relevant literature to support the discussion on osteoporosis and patient care, providing a comprehensive overview of the topic.

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Clinical Placement Preparation
student
10/4/2019

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Table of Contents
Introduction.................................................................................................................................................2
Clinical preparation.................................................................................................................................2
Reflection................................................................................................................................................3
Conclusion...................................................................................................................................................4
References...................................................................................................................................................5

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Introduction
As people age, they experience different types of health issues. They Osteoporosis are the
bone disorder that causes bones density. The body in this health issue reabsorb additional bone
tissue and generates less to replace it (Wang & McCauley, 2016). In this particular report, the
osteoporosis in the elderly patient will be discussed.
Clinical preparation
I am working in an aged care hospital where most of the patient admitted for the bine
related issues. Older people with osteoporosis experience porous and weaker bones which
increases the risk of fractures mostly in the hip, spinal vertebrae and different peripheral joints.
Some of the symptoms associated with osteoporosis are back pain, which is caused by the
fracture or collapsed vertebra, loss of height over time, a stooped posture, bine breaks easily than
expected. There are different risk factors of this health issues such as being women and older,
family history of osteoporosis, reduced levels of sex hormones, thyroid problems, low calcium
intake, eating disorder, gastrointestinal surgery etc (Jia et al., 2017). some of the lifestyle choices
can also cause this bone problem like sedentary lifestyle, consuming more alcohol, and tobacco
use. Some of the treatment options available for these health issues include using
bisphosphonates (such as alendronate, Risedronate, Zoledronic acid etc.), monoclonal antibody
medicines, hormonal therapy, and using bone-building drugs. Monoclonal antibody drugs like
Denosumab show similar and better results of bone density and decrease the chances of fracture.
In hormonal therapy, Raloxifene can be used for bone density to women and testosterone
replacement therapy can be used for men. The bine building medicines like Teriparatide (forteo),
Abaloparatide (Tymlos), and Romosoumab (Evenity). Teriparatide is the powerful drug

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stimulates the growth of new bones, Abaloparatide is similar to the parathyroid hormone, and
Romosozumab is the latest bone-building drug to address osteoporosis (Khosla & Hofbauer,
2017).
Some of the older may also receive palliative/end of life care in the deterioration
condition. As a registered nurse it is our responsibility to provide the best care to the patient.
Palliative care includes the complete spectrum of care: medicinal, nursing, mental, social,
cultural, and spiritual (George et al., 2016). It is the holistic approach that incorporates the wide
aspects of the care, and favourable medical practice. In the aged care hospital, palliative care is
provided at both the hospital and home. The main role registered nurses in palliative care to
assist the patient and family in coping with the current situation. Nurses are skilled with effective
communication which help in building a therapeutic relationship with the aged person and their
family (Cagle et al., 2017). Choices about the care during the end days of life often include
quality of life consideration. Nurses are required to deliver effective care which includes the
comfort promotion, relief from the pain, and systems, and helping the patient with medication
other requirements. Registered nurses must include sensitivity, empathy and compassion, and
show concern for the person. Before initiating the treatment process, the nurses must receive the
consent form from the patient or family members (Caswell, Pollock, Harwood & Porock, 2015).
Reflection
I have to work in the aged care hospital as a registered nurse for the last 2 years. I have
dealt with different cases of osteoporosis. It increased my understanding of the importance of
being empathetic and concerned for the battement of the patient. Most of her patient with
osteoporosis need an immediate release from pain and sometimes become aggressive. I think
nurses need to be calm and available for the patient in an adverse situation. We must also give

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them some space as at the end of life days people want to spend most of their time with their
family member or partner. I have been involved in many palliative care cases and provided my
services positively. In my opinion, the role of nurses I palliative care is increasing as if the
patient receiving palliative and in the hospital, and have nobody to decide on their behalf, nurses
can help them to decide on their care.
Conclusion
Osteoporosis is the bone disorder in which the bone density is reduced. In the aged care
hospital, most of the older patient suffering from osteoporosis. The treatment option available for
such patient is a monoclonal antibody, hormonal therapy and drug therapy. Nurses should
address the older person receiving palliative care with empathy and respectfully.

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References
Cagle, J. G., Unroe, K. T., Bunting, M., Bernard, B. L., & Miller, S. C. (2017). Caring for dying
patients in the nursing home: Voices from frontline nursing home staff. Journal of Pain
and symptom management, 53(2), 198-207.
Caswell, G., Pollock, K., Harwood, R., & Porock, D. (2015). Communication between family
carers and health professionals about end-of-life care for older people in the acute
hospital setting: a qualitative study. BMC palliative care, 14(1), 35.
George, N., Phillips, E., Zaurova, M., Song, C., Lamba, S., & Grudzen, C. (2016). Palliative care
screening and assessment in the emergency department: a systematic review. Journal of
Pain and Symptom Management, 51(1), 108-119.
Jia, T., Byberg, L., Lindholm, B., Larsson, T. E., Lind, L., Michaëlsson, K., & Carrero, J. J.
(2015). Dietary acid load, kidney function, osteoporosis, and risk of fractures in elderly
men and women. Osteoporosis International, 26(2), 563-570.
Khosla, S., & Hofbauer, L. C. (2017). Osteoporosis treatment: recent developments and ongoing
challenges. The lancet Diabetes & endocrinology, 5(11), 898-907.
Wang, C. W. J., & McCauley, L. K. (2016). Osteoporosis and periodontitis. Current
osteoporosis reports, 14(6), 284-291.