# A nurse is caring for a 68-year-old female client diagnosed with osteoporosis. Which nursing intervention is most appropriate to prevent complications associated with this condition? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=541081 > language: ko > subject: Adult Health ## 문제 A nurse is caring for a 68-year-old female client diagnosed with osteoporosis. Which nursing intervention is most appropriate to prevent complications associated with this condition? ## 보기 1. Encourage complete bed rest to prevent further bone loss 2. Administer calcium supplements without vitamin D 3. Implement fall prevention strategies and weight-bearing exercises **✔ 정답** 4. Restrict fluid intake to reduce bone mineral loss **정답: 3** ## 해설 Fall prevention strategies and weight-bearing exercises are essential for osteoporosis to maintain bone density and prevent fractures, the most serious complication. Other options are inappropriate: bed rest accelerates bone loss, calcium without vitamin D is ineffective, and fluid restriction does not prevent bone loss. ## 심화 해설 Understanding Osteoporosis and Its Primary Complication Osteoporosis is a metabolic bone disease characterized by compromised bone strength, predisposing a client to an increased risk of fracture. The central clinical concern in managing a 68-year-old female client with this diagnosis is not the bone loss itself, but the prevention of fragility fractures, which are fractures that occur from a force equivalent to a fall from standing height or less [1,2]. These fractures, particularly of the hip, spine, and wrist, lead to significant morbidity, loss of independence, and increased mortality. Therefore, the most appropriate nursing interventions directly target the reduction of fall risk and the mechanical stimulation of bone to maintain its density. Analysis of Correct and Incorrect Interventions The correct answer is to implement fall prevention strategies and weight-bearing exercises. This approach is a cornerstone of non-pharmacological management recommended in major clinical guidelines for osteoporosis [1,2]. The rationale is twofold. First, fall prevention strategies, such as environmental safety checks, adequate lighting, and non-slip footwear, directly mitigate the primary mechanism—a fall—that leads to a fragility fracture. Second, weight-bearing and resistance exercises provide an osteogenic stimulus. Mechanical loading on the skeleton is essential for bone health; it triggers bone formation and helps preserve bone mineral density (BMD). A network meta-analysis has demonstrated that specific aerobic exercise prescriptions can positively affect bone density in patients with osteoporosis [3]. Furthermore, high-intensity training has been shown in a meta-analysis to increase levels of osteocalcin, a key biomarker of bone formation, indicating that systematic exercise promotes bone remodeling [4]. The other options are inappropriate and can be harmful. - Encouraging complete bed rest is contraindicated. Immobilization leads to rapid bone resorption and a significant decrease in BMD due to the lack of mechanical stress on the skeleton, which accelerates the disease process and increases fracture risk. - Administering calcium supplements without vitamin D is ineffective and not aligned with clinical guidelines. Vitamin D is critical for intestinal calcium absorption. Without adequate vitamin D, calcium supplementation cannot be effectively utilized for bone mineralization. Guidelines emphasize the importance of ensuring sufficient vitamin D status alongside adequate calcium intake [1,2]. - Restricting fluid intake has no physiological basis for reducing bone mineral loss. In fact, adequate hydration is important for overall health, and dehydration can increase the risk of orthostatic hypotension and falls, thereby paradoxically increasing fracture risk. Integrating Evidence into Clinical Practice The 2022 update of the UK National Osteoporosis Guideline Group (NOGG) guideline explicitly states that management must include lifestyle measures such as maintaining physical activity and ensuring adequate nutrition, alongside pharmacological therapy when indicated [2]. The evidence from recent meta-analyses reinforces this by quantifying the biological effect of exercise. While general physical activity is beneficial, a structured exercise prescription that includes high-intensity or weight-bearing components appears to have a measurable impact on bone remodeling markers like osteocalcin [4] and can improve BMD [3]. In a nursing care plan, this translates to collaborating with physical therapy to design a safe, individualized exercise regimen and conducting a thorough home safety assessment to identify and correct fall hazards. The synergy of these two interventions—strengthening bone through targeted exercise and protecting it from trauma through fall prevention—provides the most comprehensive strategy to prevent the devastating complication of a fragility fracture.References (research sources) - [2]UK clinical guideline for the prevention and treatment of osteoporosisGuidelineCelia L. Gregson, David Armstrong, Jean Bowden, Cyrus Cooper, John Edwards, Neil Gittoes (2022) · DOI: 10.1007/s11657-022-01061-5 - [3]A network meta-analysis of the effects of different aerobic exercise prescriptions on bone density in osteoporosis patients.Meta-analysis/systematic reviewZhou X, Yang N, Xi C, Ji J, Xu T. (2026) · DOI: 10.3389/fendo.2026.1828031 - [4]High-Intensity Training Increases Osteocalcin Levels: A Meta-Analysis of Effects of Exercise on Bone Remodeling biomarkers.Meta-analysis/systematic reviewBarna V, Makolli A, Benyó ZP, Engh MA, Zolcsák Á, Teutsch B, Seymour V, Hegyi P, Papp R, Sydo N, Ferdinandy P. (2026) · DOI: 10.1186/s40798-026-00986-2 ## 임상 시나리오 Osteoporosis: Fracture PreventionNon-Pharmacological Management Priorities The primary goal in managing osteoporosis is preventing fragility fractures, most commonly from falls. The cornerstone nursing intervention combines fall prevention strategies with weight-bearing exercises. Fall prevention includes environmental safety checks, ensuring adequate lighting, removing tripping hazards, and using non-slip footwear. These actions directly mitigate the primary mechanism leading to fracture. Weight-bearing and resistance exercises (e.g., walking, stair climbing) provide an osteogenic stimulus. Mechanical loading on the skeleton triggers bone formation and helps preserve bone mineral density (BMD). CautionAvoid recommending complete bed rest, as immobility accelerates bone resorption. Calcium supplementation must be paired with adequate vitamin D to ensure absorption. ## 핵심 개념 - **Osteoporosis** — A metabolic bone disease characterized by low bone mass and microarchitectural deterioration, leading to increased fracture risk. - **Fragility Fracture** — A fracture resulting from a mechanical force that would not ordinarily cause a fracture, such as a fall from standing height or less. - **Weight-Bearing Exercise** — Physical activity where bones and muscles work against gravity, providing mechanical stress that stimulates bone formation and preserves bone mineral density. ## 같은 주제 문제 - [A 68-year-old postmenopausal woman comes to the clinic for a routine health assessment. Wh…](https://mymerci.kr/pages/nclex_q.php?qn_id=541077) - [A nurse is assessing a 72-year-old postmenopausal woman who reports chronic back pain and …](https://mymerci.kr/pages/nclex_q.php?qn_id=541078) - [A nurse is assessing a 68-year-old postmenopausal woman who has been diagnosed with osteop…](https://mymerci.kr/pages/nclex_q.php?qn_id=541079) - [A nurse is caring for a 72-year-old male client diagnosed with osteoporosis. Which nursing…](https://mymerci.kr/pages/nclex_q.php?qn_id=541080) - [A nurse is caring for a 68-year-old female client diagnosed with osteoporosis. Which nursi…](https://mymerci.kr/pages/nclex_q.php?qn_id=541082) --- More free questions: [기출문제](https://mymerci.kr/) _학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._