Page 2157 - Saunders Comprehensive Review For NCLEX-RN

supplements).
3. Treatment is aimed at reducing the occurrence of
fractures by maintaining or increasing bone strength.
4. Medications that decrease bone resorption
(antiresorptive) and medications that promote bone
formation are used (Box 61-3).
5. Antiresorptive medications include raloxifene,
calcitonin, and bisphosphonates.
6. Teriparatide promotes bone growth.

B. Interventions

1. Calcitonin-salmon
a. Calcitonin is secreted by the thyroid
gland and inhibits osteoclastic bone
resorption.
b. Instruct the client on how to administer
the intranasal or subcutaneous form,
depending on the route prescribed.

c. Intranasal route: Examine the

nares for irritation; alternate nostrils
for doses.

d. When calcitonin is taken, it is

important to monitor for
hypocalcemia.
2. Bisphosphonates
a. Bisphosphonates inhibit osteoclast-
mediated bone resorption, thereby
increasing total bone mass.
b. Bisphosphonates include alendronate,
risedronate, ibandronate, pamidronate,
and zoledronic acid.

c. Contraindicated for clients with

esophageal disorders that can impede
swallowing and for clients who cannot
sit or stand for at least 30 minutes (60
minutes with ibandronate)
d. Adverse effects include esophagitis,
muscle pain, and ocular problems; the
client is instructed to contact the PHCP
if adverse effects occur.

Because of the risk of esophagitis,

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