Here we’ll create a scenario-based sample osteoporosis nursing care plan. It will include nursing assessment, nursing diagnosis, desired outcome/goal, and nursing interventions with rationale for osteoporosis.
Osteoporosis Case Scenario
An 81-year old female presents the ED with complaints of hip pain following a fall at home. The patient said she tripped over a cord on the floor and fell on her hip.
She experienced severe pain and was unable to stand up, so she called her daughter who subsequently called an ambulance.
The patient has no past medical history that she’s aware of, and reports not seeing a doctor for over 10 years.
Upon assessment, the patient is alert and oriented and follows commands appropriately. She appears very frail and only weighs 81 kg. When asked if she has lost weight recently the patient says, “No- but I used to be 165 cm tall, and now I’m only 157 cm tall!”
Her right hip is bruised and she is not able to move around in the bed without significant discomfort. Her vital signs are unremarkable.
An x-ray of the patient’s hip confirms a right hip fracture.
The patient’s blood work also reveals low calcium of 7.9 mg/dL, low magnesium of 1.7 mg/dL, and a 25-hydroxy vitamin D level of 11 ng/mL, indicating severe vitamin D deficiency.
A bone density scan is performed, and the patient has a T-score of -2.6, confirming below-average bone density.
The patient is diagnosed with Osteoporosis.
See Also
Chronic pain nursing care plans
#1 Sample Nursing Care Plan for Osteoporosis – Imbalanced nutrition
Nursing Assessment
Subjective Data:
- The patient reports losing 8 cm of height.
Objective Data:
- The patient’s blood work reveals low calcium, magnesium, and vitamin D.
- Confirmed right hip fracture and low bone density.
Nursing Diagnosis
Imbalanced nutrition: less than body requirement related to calcium and vitamin D deficiencies as evidenced by hip fracture and low bone density.
Goal/Desired Outcome
Short-term goal: By the end of the shift the patient will recognize the relationship between bone health and calcium and vitamin D.
Long-term goal: The patient will consume a balanced diet with calcium and vitamin D supplements, and will see an improvement in deficiencies.
Nursing interventions with rationales for Osteoporosis – Imbalanced nutrition
| Nursing Interventions | Rationales |
| Educate the patient about calcium requirements. | Patients less than 50 years old should consume 1000 mg of calcium per day. Adult women should increase their consumption to 12000 mg after 50 years of age, and adult men should similarly increase their consumption after 70 years of age. If unable to consume enough dietary calcium, supplements such as calcium carbonate or calcium citrate may be required. |
| Educate the patient about vitamin D requirements. | Vitamin D is essential for calcium absorption. Adults over 50 should aim to consume 1000 IU of vitamin D per day. |
| Consume a diet high in calcium, vitamin D, and protein. | Examples of foods high in calcium are dairy products and green leafy vegetables. Examples of foods high in vitamin D include fatty fish, cheese, egg yolk, and fortified kinds of milk. |
| Advise the patient to get 15 minutes of sunlight a day. | Vitamin D is synthesized in the skin with sunlight exposure. 15 minutes of sunlight a day is recommended. |
| Limit alcohol and caffeine consumption. | Excess caffeine and/or alcohol consumption increases the risk of developing osteoporosis. |
| If possible, avoid long-term use of corticosteroids and PPIs. | Long-term use of these medications increases the risk of developing osteoporosis. An example of a corticosteroid is hydrocortisone, and an example of a PPI is omeprazole. |
#2 Sample Nursing Care Plan for Osteoporosis – Impaired physical mobility
Nursing Assessment
Subjective Data:
- The patient fell at home and is having difficulty moving independently in bed.
Objective Data:
- Confirmed right hip fracture and low bone density.
Nursing Diagnosis
Impaired physical mobility related to low bone density secondary to osteoporosis as evidenced by hip fracture and recent fall.
Goal/Desired Outcome
Short-term goal: By the end of the shift, the patient will understand how osteoporosis contributed to her hip fracture.
Long-term goal: The patient will be compliant with osteoporosis medications, and will see a subsequent increase in bone density.
Nursing interventions with rationales for Osteoporosis – Impaired physical mobility
| Consider estrogen/progesterone administration. | Following menopause, the decrease in estrogen and progesterone leads to a decrease in bone density. While hormone therapy can decrease the risk of fractures and increase bone density, estrogen therapy also increases the risk of stroke, breast cancer, and cardiovascular disease. |
| Consider parathyroid hormone administration. | This therapy increases bone formation. Examples include Abaloparatide (Tymlos) or Teriparatide (Forteo). |
| Use mobility aids as needed. | Assistive devices such as a walker or cane may be required to increase mobility. |
#3 Sample Nursing Care Plan for Osteoporosis – Risk for injury
Nursing Assessment
Subjective Data:
- The patient fell at home and fractured her hip.
Objective Data:
- Confirmed right hip fracture and low bone density.
Nursing Diagnosis
Risk for injury related to weakened and fragile bones secondary to osteoporosis as evidenced by fractured right hip.
Goal/Desired Outcome
Short-term goal: By the end of the shift the patient will remain safe with no further falls or injuries.
Long-term goal: The patient will state the importance of fall prevention and will enact the necessary changes at home to prevent future falls.
Nursing interventions with rationales for osteoporosis – Risk for injury
| Nursing Interventions | Rationales |
| Enact fall risk precautions. | Instructing the patient to call for help, setting a bed alarm, and using non-skid socks are all interventions to prevent falls in the hospital. At home, the patient should decrease clutter, remove obstacles, and adhere loose rugs to prevent falls. |
| Coordinate physical therapy. | Physical therapy is especially important after a broken hip to rehabilitate the patient and return to baseline levels of activity. It is also important for patients with osteoporosis to build strength and increase their range of motion. |
| Coordinate occupational therapy. | Occupational therapy can help the patient remain independent and complete ADLs at home. |
| Educate the patient about recurrent bone density scans. | Bone density scans can evaluate progress and assess the success of medications and dietary changes. |
Conclusion
To conclude, here we have formulated a scenario-based nursing care plan for osteoporosis. Prioritized nursing diagnosis Imbalanced nutrition: less than body requirement, impaired physical mobility, and risk for injury.
Here you can find acute pain and chronic pain nursing care plans.
Additionally, this sample nursing care plan for osteoporosis includes nursing assessment, NANDA nursing diagnosis, and interventions with rationales.
Recommended Readings & References
Ackley, B., Ladwig, G., Makic, M., Martinez-Kratz, M., & Zanotti, M. (2020). Nursing Diagnoses Handbook: An Evidence-based Guide to Planning Care (12th ed.). Elsevier.
Doenges, M., Murr, A., & Moorhouse, M. (2019). NURSING CARE PLANS: Guidelines for Individualizing Client Care Across the Life Span (10th ed.). F. A. Davis Company.
Herdman, T., Kamitsuru, S. & Lopes, C. (2021). NURSING DIAGNOSES: Definitions and Classifications 2021-2023 (12th ed.). Thieme.
Swearingen, P. (2016). ALL-IN-ONE CARE PLANNING RESOURCE (4th ed.). Elsevier/Mosby.
