Osteoporosis

Clinical Guidelines for Prevention, Diagnosis, and Management

By: Sarah Hall Gueldner (Editor), Eric D. Newman (Editor), Theresa Grabo (Editor), David Cooper (Editor)

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Paperback | 30 January 2012 | Edition Number 2

At a Glance

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280 Pages

Edition Type
Revised

Dimensions(cm)
25.3 x 17.98 x 1.6

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This clinical guide for nursing and other health care professionals, particularly advanced practice nurses, describes the extent of the problem of osteoporosis, the pathogenesis, clinical presentation, diagnostic testing, treatments, and current and emerging prevention strategies. The incorporation of clinical protocols and practice guidelines makes this an important reference for clinicians caring for patients of all ages as current research points to the need to help children and teenagers develop maximum bone density in the early years to prevent osteoporosis in later life.

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Contributors	p. xi
Foreword	p. xiii
Preface	p. xv
Acknowledgments	p. xvii
Introduction and Overview	p. 1
The Problem	p. 1
The Science	p. 1
Transferring Knowledge to Practice	p. 2
The Clinical Mandate	p. 2
Children: An Overlooked At-Risk Group	p. 2
The System Mandate	p. 3
The Purpose of This Book	p. 3
Summary	p. 5
Prevalence, Risk Factors, and Pathogenesis
Demographic Perspectives: The Magnitude of Concern	p. 9
Introduction	p. 9
Prevalence	p. 10
Fractures	p. 11
Lifetime Fracture Risks	p. 11
Global Perspectives	p. 12
Consequences of Osteoporosis	p. 13
Future Projections	p. 16
The Pathogenesis of Osteoporosis	p. 19
Introduction	p. 19
Bone Physiology	p. 20
Conclusion	p. 28
Clinical Management
Diagnostic Tests and Interpretation	p. 33
Introduction	p. 33
Bone Mineral Density Testing	p. 33
Guidelines for Interpretation	p. 35
Clinical Utility	p. 38
Markers of Bone Turnover	p. 39
Secondary Cause Evaluation	p. 40
Pharmacological Management	p. 47
Bisphosphonate Therapy	p. 48
Parathyroid Hormone Therapy (PTH)	p. 52
Estrogen Therapy	p. 53
Bioidentical Hormones	p. 57
Selective Estrogen Receptor Modulators (SERMs)	p. 59
Calcitonin (Salmon) Therapy	p. 64
Combination Antiresorptive Therapy	p. 66
Calcium and Vitamin D	p. 67
Vitamin D	p. 69
Integrative Therapies	p. 72
Pain Management	p. 73
Conclusion	p. 76
Surgical Management of Fractures	p. 83
Complications of Osteoporosis	p. 83
Hip Fractures	p. 84
Vertebral Compression Fractures	p. 88
Wrist Fractures	p. 97
Prevention	p. 99
Conclusion	p. 99
Nonpharmacological Management
Diet and Bone Health	p. 103
The Effect of Calcium on Peak Bone Mass	p. 104
Does Calcium Intake Minimize Bone Loss and Reduce Fractures?	p. 104
Recommended Calcium Intakes	p. 105
The Calcium Paradox	p. 106
Food Sources of Calcium	p. 106
Vitamin D	p. 107
Sources of Vitamin D	p. 108
Recommended Vitamin D Intakes	p. 109
How Much Calcium and Vitamin D Is Available in Foods and Supplements?	p. 109
Is It Possible to Consume Too Much Calcium and Vitamin D?	p. 109
Total Diet	p. 110
Nutritional Recommendations	p. 112
Summary	p. 113
Exercise Mandate: Preventative and Restorative	p. 117
Preventative	p. 118
Restorative	p. 127
General Considerations	p. 132
Summary	p. 133
Osteoporosis and Fall Prevention	p. 141
Elements of a Fall Prevention Program	p. 143
HEROS Fall Prevention Program for Community Dwelling Older Adults	p. 148
Maintaining Independence and Quality of Life	p. 153
Client-Centered Approach	p. 154
Setting Goals for Lifestyle Redesign	p. 155
Integrating Interdisciplinary Assessments	p. 155
Common Problems Affecting Independence and Quality of Life	p. 159
Lifestyle Redesign for Living With Osteoporosis	p. 161
Successful Lifestyle Redesign-Outcomes and Prognosis	p. 164
Summary	p. 164
Prevention Strategies
Maximizing Peak Bone Mass in Children, Adolescents, and Young Adults: A Public Health Priority	p. 169
Nutrition	p. 170
Physical Activity	p. 173
Medications	p. 174
Medical Conditions	p. 175
Prevention Programs	p. 177
A Model for Improving Access to Osteoporosis Care: The Geisinger Health System Mobile DXA Program	p. 181
Osteoporosis Testing	p. 181
Heel Ultrasound-A Helpful but Incomplete Solution	p. 182
Mobile DXA-Providing the Gold-Standard Test at the Convenience of the Patient's Primary Care Physician's Office	p. 183
Mobile DXA-Conclusions and Future Directions	p. 185
A Model for Community Outreach: Cooperative Extension Osteoporosis Prevention and Screening Programs	p. 187
Introduction	p. 187
About cooperative Extension	p. 188
Creating Health: Osteoporosis	p. 190
Other Program Examples	p. 192
Summary	p. 198
Health Policy and Insurance Reimbursement	p. 201
Policy Makers and Stakeholders	p. 202
Reimbursement: Federal	p. 208
Policy and Reimbursement: Individual States in the United States	p. 209
Policy Development: Case Studies	p. 214
Summary	p. 216
Emerging Approaches in the Prevention of Osteoporosis	p. 219
Introduction	p. 219
Bone Adaptation and Fluid Flow	p. 220
Fluid Flow in Humans	p. 221
Skeletal Muscle Pump Stimulation and Bone Health	p. 224
Concluding Remarks	p. 228
Acknowledgments	p. 229
Resources and Related Links	p. 235
Federal Government	p. 255
State Government	p. 238
Nongovernment	p. 239
Diagnoses That Support Medical Necessity for Bone Densitometry for Reimbursement	p. 241
Index	p. 247
Table of Contents provided by Ingram. All Rights Reserved.

Osteoporosis

Clinical Guidelines for Prevention, Diagnosis, and Management

At a Glance

Paperback

Shipping

How to return your order

Defective items

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