Geriatric Osteoporosis Assessment Cues (Nursing)

00:01 This is the NCSBN Nursing Clinical Judgment Model.

00:05 Now that stands for the National Council of the State Boards of Nursing.

00:10 This is their Nursing Clinical Judgment Model.

00:13 Now remember, the National Council the State Boards of Nursing, are the overseers, the authors of your NCLEX exam.

00:22 that you'll take either your NCLEX LPN, or your NCLEX RN.

00:27 So you want to make sure that this thing doesn't intimidate you.

00:32 Because it's really not as scary as it looks.

00:34 Just like any other model, if you break it down, take it line by line, it's going to be pretty straightforward.

00:41 Here's the part I want you to focus on.

00:43 Look at the bottom where it talks about cues.

00:47 Now the first of those steps, they want you to be able to recognize cues, analyze cues, and then develop a hypothesis.

00:55 So let's just focus on that or we're thinking about the nursing clinical judgment model.

01:00 Now, this is also the model that's used on your NCLEX exam to help you answer special questions.

01:06 So don't look at this as like, "Oh, my goodness, this is so scary." It's really not.

01:11 This is what you would expect a nurse to do.

01:14 You expect him to recognize, "Oh-oh, I see that.

01:16 And when I see this and that I put it together, and no, this could be a problem.

01:21 Now let's get practical.

01:23 I want to give you an idea of the type of assessment cues you should be looking for in geriatric patients regarding osteoporosis.

01:31 Now, when does this pay off for you, whoo, on exam questions, but most importantly, in your practice.

01:38 Whether it's with your clients, or people that you know and love in your family, or circle of influence.

01:44 These are the things you want to be on the alert for.

01:47 If an elderly patient complains of back pain, keep in mind that this could be caused by a fractured or collapsed vertebra.

01:56 Now what causes that is remember those vertebral compression fractures.

02:02 Now you see that we have a picture of that for you right there.

02:05 So you can see what that vertebral compression fracture looks like.

02:08 You see that kind of that darkened spot on the bone.

02:12 Let's talk about what other things you're going to see if someone is suffering from vertebral compression fractures.

02:18 Let's take a look at a client over a period of time.

02:21 Now we know that back pain is a cue.

02:23 We want to watch that when we're assessing geriatric patients, when we're having conversation with geriatric patients, even in our social circles.

02:32 This could be caused by that collapse vertebra.

02:34 Now it's going to cause them to lose height over time.

02:38 But think about as a health care provider, I could look at their recorded height over the last five years or 10 years, or whatever information I have access to.

02:47 You can also ask the client.

02:49 "Hey, have you noticed a change in your height?" Don't tell them, "Have you noticed you're shorter?" Just ask them, "Have you noticed any change in your height?" Now, rarely do people get taller, but given the open ended question, what changes have you noticed in your height over time is an even better question.

03:09 You don't ask them yes or no.

03:11 it's more therapeutic, and you will get better information.

03:15 So ask them, what changes in your height have you noticed over the last five or 10 years? And see what information you get.

03:24 Be on the lookout for additional cues.

03:27 Now, this stooped posture, right? That's from those vertebral fractures.

03:32 We know this client likely has had vertebral compression fractures.

03:37 That's why they have that stooped posture.

03:40 They have that kind of like that extra hump in their back, they're hunched over.

03:44 This is usually a dead giveaway that this is what the patient has been experiencing.

03:49 Remember, geriatric clients with osteoporosis have bones that break much more easily than you would expect.

03:57 So small injuries can lead to fractures that we wouldn't expect someone in their 30s.

04:03 Ask your clients about the types of medication they're on.

04:05 Be alert.

04:07 Know if they're on any one of those seven medications that we discussed, that can cause bone loss.

04:12 You want to bring that to the attention of your client and to the health care provider.