Pathophysiology Case Study: Osteoporosis

Week 8 Case Study

Directions: Read the attached case study and answer “Discussion Questions”. Question and answer format is appropriate for this assignment. However, the document should contain an APA formatted title and reference page, and all references should be cited in the body of the paper.

Chapter 12

Pathophysiology Case Study: Osteoporosis

Patient Overview:

Sarah Miller is a 68-year-old woman who presents to the clinic for a routine check-up. She has a history of low back pain for the past six months, particularly after standing for long periods. She also reports a recent incident where she tripped over a rug and broke her wrist. She has noticed that she is losing height, and her posture has become more stooped in the past year. She is post-menopausal and has a family history of osteoporosis, as both of her parents had fractures later in life. Sarah’s medications include calcium and vitamin D supplements, but she is not currently on any specific osteoporosis treatment.

Physical Examination:

Upon examination, Sarah has a noticeable kyphosis (rounded upper back). She is 5’2″ and weighs 135 pounds. Her vital signs are within normal limits, but her height has decreased by 1.5 inches over the past five years. The wrist fracture healed poorly, with some residual discomfort. On palpation, her spine shows some tenderness, and she reports mild pain in her lumbar region. Her grip strength is slightly reduced in her right hand.

Diagnostic Tests:

Bone Mineral Density (BMD) Test: A DEXA scan reveals a T-score of -2.8 in the lumbar spine and -2.5 in the hip, which confirms osteoporosis.
Serum Calcium and Vitamin D: Levels are within normal range, but her 25-hydroxyvitamin D level is slightly low.
X-ray of the Spine and Wrist: Mild compression fractures are noted in the lumbar vertebrae, and the wrist fracture shows signs of delayed healing.
Discussion Questions :

At the cellular level, how does osteoporosis occur?
What are the common clinical presentations of osteoporosis in patients like Sarah?
How do treatments such as bisphosphonates and calcium/vitamin D supplementation help improve osteoporosis?
This case study provides an opportunity for advanced practice nursing students to explore the pathophysiology, clinical manifestations, and treatment options for osteoporosis, emphasizing the importance of early recognition and management to reduce fracture risk and improve quality of life.

Rubric
Case Study Rubric
Case Study Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent Knowledge
40 pts
Excellent work
-Follows all requirements for the assignment. -Conveys well-rounded knowledge of the topic. -Excels in fully presenting what is known about the topic.
20 pts
Meets Expectations
-Follows all requirements for the assignment. -Major points of topic are mostly covered in the required assignment areas.
10 pts
Needs Improvement
-Knowledge of topic is partially covered. -Key information is missing from 2 or more assignment areas.
0 pts
Not Acceptable
-Knowledge of topic is general and does not cover all the required assignment areas.
40 pts
This criterion is linked to a Learning OutcomeFlow of Content
15 pts
Excellent work
-Well-organized. -Information flows in logical and interesting sequence. -Easy to read, follow, and understand throughout. -Captures the reader’s attention.
10 pts
Meets Expectations
-Organized. -Information flows in logical and interesting sequence. -Easy to read, follow, and understand through most of presentation.
5 pts
Needs Improvement
-Organization, sequence, and flow of presentation are difficult to follow at times. -Information is difficult to read or understand in a few areas.
0 pts
Not Acceptable
-Paper is not well organized. -Information is difficult to read, understand, and follow throughout most of the paper.
15 pts
This criterion is linked to a Learning OutcomeClarity, Critical Thinking
25 pts
Excellent work
-Concisely explains the topic. – Consistently analyzes information, offers insight, and draws conclusions. -Excels in presentation of ideas. -Scholarly work.
12.5 pts
Meets Expectations
-Explains the topic. -Presents information about the topic. -Some analysis, insight, and conclusions offered. -Scholarly work.
5 pts
Needs Improvement
-Major aspects of the topic are presented, but content lacks insight and analysis.
0 pts
Not Acceptable
-Information is basic. -Major aspects of the topic are missing or inadequate. -Lacks insight, analysis, and conclusions. -Reader gains little understanding of the topic.
25 pts
This criterion is linked to a Learning OutcomeWriting Composition (Spelling, Grammar, Sentence Structure)
10 pts
Excellent work
-An occasional error may occur, but writing, grammar, spelling, transitions, readability, and sentence structure are essentially error free.
5 pts
Meets Expectations
-Some minor errors (1-3 errors) may occur with spelling, grammar, transitions, and sentence structure but are not consistent throughout. -Errors do not interfere with the readability or comprehension of information.
2 pts
Needs Improvement
-Frequent errors (4-5 errors) occur with spelling, grammar, transitions, sentence structure, and readability throughout.
0 pts
Not Acceptable
-Numerous errors (>6 errors) occur with spelling, grammar, transitions, and sentence structure, throughout, which make it very difficult to read and understand the information presented.
10 pts
This criterion is linked to a Learning OutcomeReferences
5 pts
Excellent work
-Information gathered from a variety of nursing journals and nursing and/or medical organization websites. -Includes a minimum of 3 current references within the last 5 years.
3 pts
Meets Expectations
-Information gathered from a variety of relevant sources. -Includes a minimum of 2 current references within the last 5 years.
1 pts
Needs Improvement
-Information gathered from a variety of relevant sources. (Not all are professional sites). -Provides at least 1 reference. -References are greater than 5 years old.
0 pts
Not Acceptable
Not all references are appropriate, not from scholarly sources. -No references cited
5 pts
This criterion is linked to a Learning OutcomeAPA Format
5 pts
Excellent work
An occasional error may occur, but the paper is essentially error-free, following APA format in the body of the paper and reference page.
3 pts
Meets Expectations
Some minor errors (1-3 errors) may occur with APA format, but errors are not consistent throughout the paper.
1 pts
Needs Improvement
Frequent errors (4-5 errors) occur with APA format throughout the paper.
0 pts
Not Acceptable
Numerous errors (>6 errors) occur with APA format consistently throughout the paper, indicating that little effort was placed on understanding the format guidelines.
5 pts
Total Points: 100