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Osteomalacia is a metabolic bone disease characterized by a lack of bone mineral (resembles a disease that strikes children, called rickets) in adults, osteomalacia include chronic and skeletal deformities, there was not as severe as that affects children as in adults bone growth is complete.
Etiology of Osteomalacia
The cause is characterized by a state of vitamin D deficiency (calcitrol), where an increase in the absorption of calcium from the digestive system and the provision of bone mineral. provision of calcium and phosphate in the extra cellular fluid slowly. Without inadequate vitamin D, calcium and phosphate will not occur in the formation of calcium in the bones.
Signs and Symptoms of Osteomalacia
a. Bone pain.
b. Deformity may arise on the back and pelvis, legs, ribs, and the presence of areas where there pseudofracture.
c. Muscle weakness when serum calcium is very low, but may rarely occur.
Pathophysiology of Osteomalacia
There are various causes of osteomalacia are generally caused disturbances of mineral metabolism. Factors that are harmful to the development of osteomalacia include errors of diet, malabsorption, gastrectomy, chronic renal failure, long -term therapy anticonvulsan (phenyton, phenobarbital) and vitamin D insufficiency (diet, sunlight). Type malnutrition (vitamin D deficiency, often classified in terms of shortage of calcium) especially towards the malfunctioning of the damage, but dietary factors and lack of knowledge about nutrition can also be a precipitating factor that happens with most common frequency in which the content of vitamin D in the diet and the lack of an error diet and lack of sunlight. Osteomalacia is likely to occur as a result of the failure of absorption of calcium or calcium deficiency of the body. Gastrointestinal disorder where the lack of absorption of fat causes osteomalacia. Other than a shortage of vitamin D (all fat-soluble vitamins) and calcium. The most recent excretion in the faeces are mixed with fatty acids. As an example of such interference can occur celiac disease, chronic obstruction of the digestive system, chronic pancreatitis and a small stomach resection. Besides liver and kidney disease can cause vitamin D deficiency, thus these organs convert vitamin D into the active to. Lastly, hyperparatiroid support the formation of calcium deficiency, osteomalacia thereby causing an increase in urinary phosphate excretion.
Examination Support of Osteomalacia
- Calcium and inorganic phosphate is low or below normal.
- Elevated alkaline phosphatase.
- X-rays showed a typical fracture (Looser's zones) on the bones of the pelvis and long bones and especially the metatarsal and metacarpal.
- Levels of vitamin D.
Differential Diagnosis
- Osteoporosis (senile or post-menopausal).
- Bone demineralization and never used.
- Bone abnormalities due to hypoparathyroidism.
Nursing Assessment for Osteomalacia
Patients with osteomalacia often complain usually:
- Bone pain in the lower back and extremities.
- Weakness. (Overview of discomfort still vague)
- Patients may have a fracture.
- During the interview, inform about the real problems are in connection with the disease (malabsorption syndrome) and dietary habits can be known.
Nursing Diagnosis for of Osteomalacia
1. Acute Pain related to weakness and possible fracture.
2. Knowledge Deficit :about the disease process and treatment procedures.
3. Impaired self-concept related to swelling of the feet, gait lackluster / weak, and spinal deformity.
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