OSTEOMALACIA AND RICKETS

  • Decalcification and softening of bones.
  • Due to a lack of vitamin D or a problem with the body’s ability to break down and use this vitamin.
  • Rickets in children.
  • In adults, the condition is called osteomalacia; and in children, it’s known as rickets. Each one is a condition where prolonged and excessive vitamin D deficiency causes bones to soften, weaken, and easily fracture.

Rickets

  • Disease of growing bones of children (in it epiphyseal plate not closed) in which defective mineralization occurs in both bone and cartilage of epiphyseal growth plate.

Osteomalacia

  • Disorder of mature bones in adult (after epiphyseal plate closure) in which mineralization of new osteoid bone is inadequate or delayed

RISK FACTORS

  • Chronic diarrhea
  • GIT malabsorption
  • Lack of exposure to sunlight
  • Pregnancy
  • Avoidance of milk
  • Sedentary lifestyle
  • Renal disease
  • Use of strong sunscreen

CLINICAL/DIAGNOSTIC MANIFESTATION

  • Fractures
  • Persistent and diffuse skeletal pain
  • Progressive deformities of bones
      1. Bowed legs
      2. Knock knees
      3. Rachitic rosary
      4. Enlarged wrists and ankles
      5. Pigeon breast
  • Progressive muscle weakness
  • Decreased serum levels of Calcium (44-107 IU/L)
  • Looser zones on X-ray.
  • Roentgenograms shows bone demineralization and multiple bone deformities. (white: more dense; otherwise: black)
  • Elevated serum alkaline phosphatase.

NURSING INTERVENTIONS

  1. Assess posture and gait, note ability to walk with or without aid.
  2. Note ability to walk requested distances.
  3. Check bony prominence for pressure sores.
  4. Assess shapes of bones throughout the body.
  5. Administer prescribed diet.
    • Rich in Calcium
    • Rich in Vitamin D (tuna, salmon, mackerel)
  6. Discuss purpose of physical therapy.
  7. Assist to a position of comfort.
  8. Administer prescribed analgesics.
  9. Gentle back massage.
  10. Instruct regarding home safety.
  11. Teach family the effects of Calcium and Vitamin D on the body and the factors affecting absorption.
  12. Teach client on the signs of fracture.
  13. Follow up care as needed.

Difference Between Osteoporosis & Osteomalacia

  • Osteoporosis refers to the degeneration of already constructed bone, making them brittle,
  • While osteomalacia is an abnormality in the building process of bone, making them soft.

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