Date of Award

1-1-2012

Document Type

Campus Access Dissertation

Department

College of Nursing

Sub-Department

Nursing Practice

First Advisor

Kathleen Scharer

Abstract

BEST PRACTICE TO PROMOTE BONE HEALTH IN POST-MENOPAUSAL WOMEN THROUGH ADEQUATE INTAKE OF

CALCIUM AND VITAMIN D

Ellen S. Adkins, BSN, RN

College of Nursing

University of South Carolina

Doctor of Nursing Practice degree

ABSTRACT

Osteoporosis has been found to be the most common systemic bone disease, characterized by reduced bone mineral density and skeletal fragility. In the United States, 80% of individuals with osteoporosis were women. Among women with osteoporosis, it was projected that one out of three would suffer a fracture of the hip, wrist , or spine, with an increased risk of one in two for women above the age of sixty. Primary prevention efforts for post-menopausal women have been based on risk analysis and promotion of behaviors to support bone health.

Adequate intake of calcium and vitamin D has been recognized as an evidence-based health behavior to promote bone health and prevent osteoporosis. The indices of bone health in post-menopausal women, which indicated adequate calcium and vitamin D intake, were calcium absorption and balance, serum vitamin D and parathyroid hormone levels, bone mineral density, and fracture risk. The goal of this project was to establish a best practice guideline to promote bone health in post-menopausal women through adequate intake of calcium and vitamin D via nutrition or supplementation.

The primary recommendation was that the best source of calcium and vitamin D for post-menopausal women was through dietary sources because of the absorption, bioavailability, and minimal side effects. The amount of calcium and vitamin D that produced a positive outcome on bone health in post-menopausal women was 1200mg of calcium and 600IU of vitamin D daily for women aged 51 to 70. For women over age seventy, calcium of 1200mg and vitamin D of 800IU daily was recommended. The most effective way to measure the adequacy of calcium and vitamin D consisted of performing a thorough history and physical exam; measuring serum vitamin D and parathyroid hormone levels, and bone mineral density; and assessing fracture risk based on each individual woman's risk factors. Health care providers have an opportunity to have an impact on bone health and prevent osteoporosis in post-menopausal women based on primary prevention, assessment of risk factors for osteoporosis, implementation of a plan of care, and encouraging bone health promotion behaviors for optimal quality of life.

Rights

© 2012, Ellen Soley Adkins

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