A nurse is caring for an older adult client who has osteoporosis. Which of the following should the nurse recognize as the pathophysiology of osteoporosis?

Choice A Reason: Pupillary dilation

Pupillary dilation can be a sign of increased intracranial pressure or brain injury, which are potential complications following a motor vehicle accident with a loss of consciousness. Assessing for changes in pupil size and reactivity is crucial in identifying neurological impairments that may require immediate intervention.

Choice B Reason: Persistent headache

A persistent headache is a common symptom following a traumatic brain injury (TBI) or concussion. It can indicate ongoing issues such as intracranial bleeding or increased intracranial pressure. Monitoring the severity and duration of the headache is important for determining the need for further medical evaluation and treatment.

Choice C Reason: Presence of hand tremors

Hand tremors are not typically associated with acute brain injuries resulting from a motor vehicle accident. They are more commonly linked to conditions such as Parkinson’s disease, essential tremor, or other neurological disorders. While tremors should be noted, they are not a primary concern in the context of post-accident assessment.

Choice D Reason: Difficulty waking

Difficulty waking, or altered level of consciousness, is a significant indicator of potential brain injury or increased intracranial pressure. It is essential to monitor the client’s level of consciousness closely, as changes can signal worsening neurological status and the need for urgent medical intervention.

Choice E Reason: Foot drop

Foot drop is a condition characterized by difficulty lifting the front part of the foot, often due to nerve damage or muscle weakness. While it can occur in the context of neurological injury, it is not a primary manifestation to assess for immediately following a motor vehicle accident with a loss of consciousness. The focus should be on more acute signs of brain injury.

Choice A Reason: Autoimmune disorder affecting the bones

Osteoporosis is not an autoimmune disorder. Autoimmune disorders involve the immune system attacking the body’s own tissues, which is not the case with osteoporosis. Osteoporosis is primarily characterized by a decrease in bone density and mass, leading to fragile bones.

Choice B Reason: Buildup of inflammation in the joints

While inflammation can affect bone health, osteoporosis is not primarily caused by inflammation in the joints. Conditions like rheumatoid arthritis involve joint inflammation, but osteoporosis involves the loss of bone density and strength, not joint inflammation.

Choice C Reason: Increase in calcium levels in the blood

An increase in calcium levels in the blood is not a characteristic of osteoporosis. In fact, osteoporosis often involves a decrease in bone calcium content, leading to weaker bones. Hypercalcemia, or high calcium levels in the blood, is associated with other conditions such as hyperparathyroidism.

Choice D Reason: Bone loss in the cortical and cancellous bones

This is the correct description of the pathophysiology of osteoporosis. Osteoporosis involves the loss of bone density in both the cortical (hard outer layer) and cancellous (spongy inner layer) bones. This loss leads to bones becoming brittle and more susceptible to fractures.