Conditions › Bones, joints & skin
Osteoporosis Nursing Care Plan and Interventions
Osteoporosis nursing care centers on preventing falls and fractures. Teach exactly how to take alendronate (empty stomach, full glass of water, upright for 30 minutes), plus weight-bearing exercise, calcium and vitamin D.
Osteoporosis nursing care plan
| Nursing problem | Goal | Key interventions |
|---|---|---|
| Risk for injury (falls and fractures) | No falls; home hazards reduced. | |
| Risk for medication harm | Takes bisphosphonates the right way; reports red flags. | |
| Health maintenance: needs teaching | Follows bone-building habits. |
Problem wording is plain-language nursing diagnosis style. Your program may require NANDA-I labels and your own assessment data.
What it is
Osteoporosis: what it is
Bone is broken down faster than it is rebuilt, so bones turn thin and fragile. Low estrogen after menopause speeds the loss. 1
Osteopenia is the milder bone loss that comes before osteoporosis.
Osteoporosis risk factors
Older age, female sex, menopause, smoking, heavy alcohol use, low body weight, inactivity, and low calcium or vitamin D. 1
Long-term steroids, PPIs and some seizure drugs also raise the risk.
Assessment: what you will see
Silent until it breaks
Often no symptoms until a fracture, usually hip, spine or wrist. Watch for height loss, a hunched upper back (kyphosis) and back pain. 1
Measure height at each visit and compare with the baseline.
DEXA scan and T-score
A DEXA scan is the gold standard. T-score between -1 and -2.5: low bone mass (osteopenia). T-score of -2.5 or lower: osteoporosis. 1,2
Screen all women 65 and older, and younger women past menopause who have risk factors.
Priority: what the nurse does first
Prevent falls, prevent fractures
Fall precautions, a clutter-free and well-lit home, nonslip shoes, and safe movement. Help with daily activities as needed. 1,2
Ask about recent falls and drugs that cause dizziness on standing.
Nursing interventions and treatment
Bisphosphonates: first-line
Alendronate, risedronate, ibandronate and IV zoledronic acid slow osteoclasts, the cells that break down bone. 3,1,4
Pills are daily, weekly or monthly. Zoledronic acid is an IV dose given about once a year.
How to take alendronate
First thing in the morning on an empty stomach, with a full glass of plain water. Stay upright 30 minutes, then eat or take other meds. 5
Never at bedtime, and never with coffee, juice or calcium.
Bisphosphonate red flags
Painful swallowing or new heartburn: stop and report. Avoid invasive dental work (jaw bone death risk). New thigh or groin pain: report. 5,4
Thigh or groin pain can come before an unusual femur fracture.
Denosumab: every 6 months
A shot under the skin every 6 months. Low calcium must be corrected first, and the client takes calcium and vitamin D. 5
Never just stop it: spine fractures can follow. Another bone drug should take over.
Raloxifene: watch for clots
Acts like estrogen on bone. Main risk is a blood clot (DVT or PE), so it is not for clients with a past clot. 5
Stop it 72 hours before and during long immobility. Hot flashes and leg cramps are common.
Client teaching
Bone-building habits
Calcium and vitamin D from food or supplements, weight-bearing exercise like walking, no smoking, and limited alcohol. 6,4
Calcium foods: dairy, salmon and dark green vegetables.
Keep studying osteoporosis in NurseLingo Pro
Everything for osteoporosis in one place. A free account gets 5 free opens of any condition; Pro opens all 277.
Test yourself: free med-surg practice questions with answers and rationales.
Frequently asked questions
What are the priority nursing diagnoses for osteoporosis?
Common nursing problems for osteoporosis include risk for injury (falls and fractures); risk for medication harm; health maintenance: needs teaching. Choose the ones your assessment supports and rank airway, breathing and circulation problems first.
What does the nurse do first for osteoporosis?
Fall precautions, a clutter-free and well-lit home, nonslip shoes, and safe movement. Help with daily activities as needed.
Which nursing intervention would be included in the care plan for a patient with osteoporosis?
Fall prevention is central: a safe, clutter-free room, good lighting, nonskid footwear and assistance with walking. Teaching includes weight-bearing exercise, calcium and vitamin D, and how to take alendronate (empty stomach, full glass of water, upright for 30 minutes).
More bones, joints & skin
Sources
- OpenStax Medical-Surgical Nursing, 13.1
- merckmanuals.com
- OpenStax Pharmacology for Nurses, 27.3
- OpenStax Pharmacology for Nurses, 36.4
- dailymed.nlm.nih.gov
- OpenStax Clinical Nursing Skills, 25.3
For study only, not medical advice. Follow your program, your facility's policies and the provider's orders.