A nurse is caring for an older adult client who has osteoporosis. Which of the following should the nurse recognize as the pathophysiology of osteoporosis?

Choice A Reason: Autoimmune disorder affecting the bones

Osteoporosis is not an autoimmune disorder. Autoimmune disorders involve the immune system attacking the body’s own tissues, which is not the case with osteoporosis. Osteoporosis is primarily characterized by a decrease in bone density and mass, leading to fragile bones.

Choice B Reason: Buildup of inflammation in the joints

While inflammation can affect bone health, osteoporosis is not primarily caused by inflammation in the joints. Conditions like rheumatoid arthritis involve joint inflammation, but osteoporosis involves the loss of bone density and strength, not joint inflammation.

Choice C Reason: Increase in calcium levels in the blood

An increase in calcium levels in the blood is not a characteristic of osteoporosis. In fact, osteoporosis often involves a decrease in bone calcium content, leading to weaker bones. Hypercalcemia, or high calcium levels in the blood, is associated with other conditions such as hyperparathyroidism.

Choice D Reason: Bone loss in the cortical and cancellous bones

This is the correct description of the pathophysiology of osteoporosis. Osteoporosis involves the loss of bone density in both the cortical (hard outer layer) and cancellous (spongy inner layer) bones. This loss leads to bones becoming brittle and more susceptible to fractures.

Choice A Reason: I will call your provider so we can discuss it

While this response shows the nurse’s willingness to involve the healthcare provider, it does not directly address the client’s concern about their ability to manage the prosthesis. It is important to provide immediate reassurance and encouragement to the client, which this response lacks.

Choice B Reason: What are you thinking that you would like to do?

This response is open-ended and encourages the client to express their feelings and thoughts. While it is a good approach to understand the client’s perspective, it does not provide the immediate reassurance and encouragement that the client needs to feel confident about managing the prosthesis.

Choice C Reason: You have the right to refuse if you don’t think you can do this

This response acknowledges the client’s autonomy but may inadvertently reinforce their doubts and fears about managing the prosthesis. It is important to encourage and support the client rather than focusing on their right to refuse.

Choice D Reason: Many clients your age are able to adjust surprisingly well to a prosthesis

This response is the most appropriate as it provides reassurance and encouragement to the client. By sharing that many clients of a similar age have successfully adjusted to a prosthesis, the nurse helps to build the client’s confidence and reduce their anxiety about managing the new situation. This positive reinforcement can be very motivating for the client.