A nurse is educating a group of adults about the risks for ...

[Tazate]

A nurse is educating a group of adults about the risks for osteoporosis. Which statements will the nurse include when discussing the use of alcohol and cigarettes? Select all that apply.
 
  A) Smoking decreases nerve supply to the bones.
  B) Nicotine increases calcium absorption, leading to decreased bone density.
  C) Moderate alcohol consumption in postmenopausal women actually may increase bone mineral content.
  D) Alcohol has a direct toxic effect on osteoclast activity, suppressing bone formation.
  E) Heavy alcohol use may be associated with nutritional deficiencies that contribute to osteoporosis.

Question 2

A client seeking treatment for severe knee pain has worked in a factory for 30 years in a position requiring repetitive lifting and carrying of 20-40-pound boxes. The nurse anticipates which recommendation from the multidisciplinary team?
 
  A) Joint replacement surgery
  B) Pharmacologic therapy
  C) Refer for Disability application.
  D) Intermittent use of a cane

[aburgess]

Answer to Question 1

Answer: C, E

Both cigarette smoking and excess alcohol intake are risk factors for osteoporosis. Smoking decreases the blood supply to bones, and nicotine slows the production of osteoblasts and impairs the absorption of calcium, contributing to decreased bone density. Alcohol has a direct toxic effect on osteoblast activity, suppressing bone formation during periods of alcohol intoxication. In addition, heavy alcohol use may be associated with nutritional deficiencies that contribute to osteoporosis. Interestingly, moderate alcohol consumption in postmenopausal women actually may increase bone mineral content, possibly by increasing levels of estrogen and calcitonin.

Answer to Question 2

Answer: B

Of these options, pharmacologic therapy would be the most likely intervention. Acetaminophen, non-steroidal anti-inflammatory, and joint injections are all possible options. Joint replacement is delayed as long as possible due to the artificial joint often requiring replacement within 15-20 years. There is not enough information to determine whether applying for Disability is appropriate at this time. A cane is not indicated at this time.