6 Ways to Protect your Bones and Assessment Cues (Nursing)

by Rhonda Lawes, PhD, RN

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    00:01 Let's take a look at six ways to protect your bones.

    00:05 This type of information is what you want to know when you're educating your patients and taking care of your own health.

    00:11 Now, what I love about this part is our artists have such a brilliant sense of humor.

    00:16 Look at the bone, see how sad he is? Well, he's gonna get a little bit happier, and a little bit happier with every strategy we bring in.

    00:24 So let's get started with the first one.

    00:26 Look at his expression.

    00:28 Now, let's look at the first strategy.

    00:30 See that, it's a little better. But it's food, right? So food actually fortifies your bones.

    00:38 You want to make sure that you eat foods rich in calcium and vitamin D.

    00:42 Now, it's particularly important that you get these vitamins from your food, if we eat a balanced diet for most of your life, you should be okay.

    00:52 But this is a conversation you're going to want each patient to have with their healthcare provider.

    00:57 Because as people age, right, after 35, we know they're losing bone mass.

    01:02 So they need to start having the conversation if they need to have supplements.

    01:07 Now, the calcium needs the vitamin D to work.

    01:11 And that's why we're saying you need both calcium and vitamin D.

    01:15 So it's always best to get these type of nutrients in real food.

    01:20 But if you need supplementation, that's a conversation that you should have with a healthcare provider.

    01:26 Yahey, exercise! Look, he's a little happier.

    01:30 But we're talking about weight bearing exercise.

    01:33 Now, that may be a strange term to you.

    01:35 But we call it like heel strike activity.

    01:38 Something I'm doing, that I have to support my body weight.

    01:42 So things like walking will help stimulate new bone formation.

    01:46 So, whether you're walking, running, you're doing resistance training, those are all good activities that will help stimulate bone growth.

    01:55 So it doesn't even have to be fancy.

    01:57 You don't have to have a gym membership.

    01:59 But you have to be active, and mobile, and do things that cause your bones to support your body weight in movement.

    02:08 Okay, it's getting better.

    02:10 But this is not anyone's favorite topic if they're a smoker, but you want to avoid smoking.

    02:16 Remember, we don't tell people, you absolutely cannot smoke.

    02:19 We try to help move them the next step toward quitting smoking.

    02:23 So maybe limiting it might be the conversation that you have with them.

    02:27 So, wants you to avoid smoking, reduce your smoking on your way to stopping smoking when you can, because smoking will also lower your estrogen levels.

    02:37 Wow, that's great. So it lowers my estrogen levels, it's toxic to my cells.

    02:44 It's a bad deal all around but you don't talk to a patient about smoking without empathy, compassion, and listening to them.

    02:54 If your patient is a tobacco user, then it is a really tough habit to quit.

    02:59 So no judgement, all support in education, helping patients take that big step, moving towards stopping altogether.

    03:10 Whoo, it's a DEXA scan.

    03:12 And we're going to do a whole video on explaining what this is.

    03:15 But let me just give you kind of a brief summary.

    03:18 Now, women should get DEXA scans starting at age 65.

    03:22 Men when they're showing off, they don't have to start getting them till they're 70.

    03:26 Okay, what are these do? Well, it's a super cool test. Doesn't hurt at all.

    03:31 You lay on a table, and it starts to tell you the strength of your bones.

    03:36 Now the reason we made this one of the ways to protect your bones is because at these ages, women 65, men 70 that gives us a baseline of where your bones are.

    03:46 Now, that's if you've not had any challenges.

    03:48 If you've had some clinical risk factors for bone loss or fracture, you may have one earlier than these ages, these recommended ages.

    03:56 However, if everything has been normal, usually women get one at 65, and men get it at 70.

    04:03 So this gives us like an inside look at how strong their bones are.

    04:08 Number five, medications.

    04:11 If you have osteopenia, that means you don't have osteoporosis yet, but osteopenia means you're at a greater risk of that.

    04:20 Your bones are kind of on that path before osteoporosis.

    04:24 So you want to make sure that you may need to consider and have the conversation with your healthcare provider, if you should start medications that slow bone loss.

    04:34 So by phosphonates are an example of a group of medications that will help to slow bone loss.

    04:41 So keep that in mind, you are going to have bone loss after age 35.

    04:48 You may not need medications, but if you do, that's one of the group of medications you may consider called by phosphonates.

    04:57 Number six, what about other health care issues.

    05:02 Well, you always want to take care of any of your health issues, but you want to make sure if you have a thyroid disorder called a parathyroid disorder.

    05:12 Okay, so you can have thyroid disorders or parathyroid disorders, or other conditions that affect your bone density.

    05:19 That's got to be taken care of. Now we will go more into detail.

    05:23 But we've kind of kind of hinted at, how hormones are really important in your bone strength.

    05:30 And if you have too much parathyroid hormone, you can end up with calcium just being ripped from your bones in a way that will make them really at risk for fractures.

    05:40 So you always want to have a regular physical visit with your health care provider, and address these issues because hormones affect everything, including your bones.

    05:51 Now, take a look at our friend. Look how happy he is.

    05:54 So if you look at all six of these strategies, you are familiar with him as a practicing healthcare worker.

    06:01 You practice them in your own life, and you'll be a much better educator of patients to help them stay safe.

    06:10 Students always want to know about the NCLEX.

    06:13 well because it's a lot of pressure.

    06:15 This is the three point framework we put into all of our videos in this series.

    06:20 We want you to be able to clearly recognize normal aging, from pathological processes.

    06:26 So you know, what's an appropriate and a safe intervention.

    06:29 Remember, the goal of clinical judgment is to recognize cues, analyze them, so you can develop hypotheses and appropriate and safe interventions.

    06:39 Second point, we want you to be very clear how age related changes can put older clients at risk for certain diseases.

    06:48 Last point, we want you to recognize the interaction of normal aging, symptoms, how they respond to treatment, and outcomes.

    06:59 Then we're gonna wrap up this section where we keep showing you this clinical judgment model, because we know you're going to see it all throughout your nursing school and on your NCLEX exam.

    07:10 Remember, this is just a graphical representation of how excellent nurses think.

    07:16 So you see, they look for recognizing cues.

    07:20 They'll analyze those, they'll develop a hypothesis, and have a plan on the appropriate interventions on how to keep patients safe.

    07:28 That's why it's a clinical judgment model.

    07:32 So let's talk about some of those assessment cues we want you to be looking for.

    07:36 You want to screen the patient for risk factors for osteoporosis.

    07:40 What would be some obvious ones for what we've just talked about with our geriatric clients.

    07:46 Right, age is one. And gender.

    07:50 If a patient is female, or if they are a transgender male, or transgender female that can add in another level of complexity to your assessment.

    07:59 You want to make sure they've had a DEXA scan at the appropriate time based on their age and risk factors.

    08:05 And take a look at their medications.

    08:07 You want to know which medications are on that could weaken the bone, and those that may build up the bone.

    About the Lecture

    The lecture 6 Ways to Protect your Bones and Assessment Cues (Nursing) by Rhonda Lawes, PhD, RN is from the course Bone Growth across the Lifespan (Nursing).

    Included Quiz Questions

    1. Vitamin D
    2. Vitamin C
    3. Vitamin A
    4. Vitamin B
    1. Walking
    2. Dancing
    3. Tennis
    4. Chair aerobics
    5. Meditation
    1. Estrogen
    2. Thyroid hormones
    3. Serotonin
    4. Dopamine
    1. Bisphosphonates
    2. Glucocorticoids
    3. Cyclosporins
    4. Thiazolidinediones

    Author of lecture 6 Ways to Protect your Bones and Assessment Cues (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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