Author Question: The nurse sees several clients with osteoporosis. For which client would bisphosphonates not be a ... (Read 106 times)

dmcintosh · **on:** Jun 25, 2018

The nurse sees several clients with osteoporosis. For which client would bisphosphonates not be a good option?

a. Client with diabetes who has a serum creatinine of 0.8 mg/dL
b. Client who recently fell and has vertebral compression fractures
c. Hypertensive client who takes calcium channel blockers
d. Client with a spinal cord injury who cannot tolerate sitting up

Question 2

A nurse is assessing an older client and discovers back pain with tenderness along T2 and T3. What action by the nurse is best?

a. Consult with the provider about an x-ray.
b. Encourage the client to use ibuprofen (Motrin).
c. Have the client perform hip range of motion.
d. Place the client in a rigid cervical collar.

apple · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: D
Clients on bisphosphonates must be able to sit upright for 30 to 60 minutes after taking them. The client who cannot tolerate sitting up is not a good candidate for this class of drug. Poor renal function also makes clients bad candidates for this drug, but the client with a creatinine of 0.8 mg/dL is within normal range. Diabetes and hypertension are not related unless the client also has renal disease. The client who recently fell and sustained fractures is a good candidate for this drug if the fractures are related to osteoporosis.

Answer to Question 2

ANS: A
Back pain with tenderness is indicative of a spinal compression fracture, which is the most common type of osteoporotic fracture. The nurse should consult the provider about an x-ray. Motrin may be indicated but not until there is a diagnosis. Range of motion of the hips is not related, although limited spinal range of motion may be found with a vertebral compression fracture. Since the defect is in the thoracic spine, a cervical collar is not needed.