OSTEOPOROSIS (Eng/Kor) for NCLEX

OSTEOPOROSIS

 

1. Definition | 정의

EN

Osteoporosis is a metabolic bone disease characterized by low bone mass, deterioration of bone tissue, and increased bone fragility, leading to a higher risk of fractures.

KR

골다공증은 골밀도 감소와 골 조직 약화로 인해 뼈가 약해지고 쉽게 골절되는 대사성 골질환이다.

 

2. Causes | 원인

Primary

• Aging
• Postmenopausal estrogen deficiency (women)
• Age-related testosterone decline (men)

Secondary

• Long-term corticosteroid use
• Hyperthyroidism or overtreated hypothyroidism
• Chronic kidney disease
• Malabsorption (celiac, Crohn’s)
• Alcohol abuse, smoking
• Anticonvulsants, PPIs, heparin
• Endocrine disorders (Cushing’s, hyperparathyroidism)

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Risk Factors | 위험요인

EN

• Age ≥ 65
• Female, postmenopausal
• Family history
• Small body frame, low BMI
• Smoking
• Excess alcohol
• Low calcium/Vitamin D intake
• Sedentary lifestyle
• Long-term steroid therapy

KR

• 65세 이상
• 여성, 폐경
• 골다공증 가족력
• 저체중, 작은 체형
• 흡연
• 과도한 음주
• 칼슘·비타민D 부족
• 운동 부족
• 장기 스테로이드 복용

4. Pathophysiology | 병태생리

EN
Imbalance between bone resorption (osteoclasts) and bone formation (osteoblasts).
→ Resorption > formation → Bone becomes porous and fragile.

KR
파골세포(뼈 흡수) > 조골세포(뼈 형성) 불균형
→ 뼈가 속이 비고 약해져 골절 위험 증가

5. Clinical Manifestations | 증상

• Often asymptomatic until fracture
• Height loss
• Kyphosis ("dowager’s hump")
• Back pain
• Fragility fractures (wrist, hip, vertebrae)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. Complications | 합병증

• Vertebral compression fractures
• Hip fractures → immobility, death risk ↑
• Chronic pain
• Decreased mobility
• Respiratory issues due to kyphosis
• Poor quality of life

7. Diagnostics | 진단 검사

EN

• DEXA scan: T-score
  • Normal: ≥ –1
  • Osteopenia: –1 to –2.5
  • Osteoporosis: ≤ –2.5
• Serum vitamin D level
• Calcium, phosphorus
• Thyroid/parathyroid tests
• X-ray (if fracture suspected)

KR

• 골밀도 검사(DEXA)
  • 정상: ≥ –1
  • 골감소증: –1 ~ –2.5
  • 골다공증: ≤ –2.5
• 비타민 D, 칼슘, 인 수치
• 갑상선·부갑상선 기능 검사
• X-ray (골절 의심 시)

8. Treatment | 치료

A. Non-pharmacologic (비약물)

EN

• Weight-bearing exercise (walking, stairs)
• Muscle-strengthening exercises
• Fall prevention
• Adequate calcium & Vitamin D
• Quit smoking
• Limit alcohol
• Home safety assessment

KR

• 체중 부하 운동(걷기, 계단)
• 근력 강화 운동
• 낙상 예방
• 칼슘·비타민 D 충분히
• 금연
• 음주 제한
• 가정 낙상 위험 점검

 

 

 

 

 

 

 

 

 

 

 

 

 

B. Pharmacologic (약물)

1. Bisphosphonates (first-line)

• Alendronate
• Risedronate
• Ibandronate
• Zoledronic acid (IV yearly)

Key teaching:

• Take in AM with full glass of water
• Stay upright for 30–60 min
• Prevent esophagitis

 

 

2. RANKL inhibitor

Denosumab (Prolia)

• SC injection every 6 months
• Risk of hypocalcemia

3. Selective estrogen receptor modulators

Raloxifene

• ↓ vertebral fractures
• Risk: DVT, hot flashes

4. Hormone therapy

Estrogen (postmenopausal) – limited use due to risk
Testosterone (in men with deficiency)

5. Parathyroid hormone analogs (anabolic)

Teriparatide, Abaloparatide

• Stimulate bone formation
• Used for severe osteoporosis

6. Calcitonin

• Nasal spray
• Less effective; used for acute pain in compression fractures

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9. Nursing Considerations | 간호중재

EN

• Assess fall risk
• Encourage weight-bearing exercise
• Ensure adequate calcium/Vitamin D intake
• Teach correct bisphosphonate use
• Monitor for jaw osteonecrosis (dental exams)
• Assess pain, posture, height changes
• Provide home safety resources
• Monitor kidney function with bisphosphonates

KR

• 낙상 위험 사정
• 체중 부하 운동 격려
• 칼슘·비타민 D 섭취 지도
• 비스포스포네이트 복용법 교육
• 턱뼈 괴사 감시(치과 검진)
• 통증·자세·신장 변화 관찰
• 가정 내 낙상 위험 점검
• 신장 기능 모니터링

10. Patient Teaching | 환자 교육

EN

• Calcium 1200 mg/day (diet + supplement)
• Vitamin D 800–1000 IU/day
• Exercise routinely
• Quit smoking
• Avoid excessive caffeine
• Prevent falls (lighting, grab bars, proper shoes)
• Report new back pain → possible vertebral fracture

KR

• 칼슘 하루 1200 mg
• 비타민 D 800–1000 IU
• 규칙적 운동
• 금연
• 카페인 과다 섭취 금지
• 낙상 예방(손잡이 설치, 조명 밝게)
• 갑작스러운 허리 통증 즉시 보고