AIIMS Delhi NO- 2019
Medical & Surgical Nursing
Hard
A patient reports calcium loss. What is the nursing intervention?
Appeared in: AIIMS Delhi NO- 2019
Explanation
- Walking is a form of weight-bearing exercise that works the bones and muscles against gravity.
- This mechanical stress stimulates osteoblasts (bone-building cells) and promotes the deposition of calcium into the bone matrix, which is essential for bone strength.
- Physical activity directly counteracts bone resorption (the process of calcium loss from bones) that is accelerated by immobility, a condition known as disuse osteoporosis.
- Promoting mobility is a key nursing intervention to prevent the demineralization and breakdown of bones.
Why Other Options Were Wrong
- Option A: Repositioning is a passive movement. While it is essential for preventing pressure injuries and promoting circulation, it does not provide the active, weight-bearing stress required to stimulate bone formation.
- Option B: This intervention is too general. While overall nutrition is important, 'supplemental feeds' does not specifically address the physiological need for mechanical stress to prevent calcium loss from bones.
- Option D: This intervention provides the raw material (calcium) but does not address the primary mechanism for its use. Without the stimulus of weight-bearing exercise, the body cannot effectively deposit calcium into the bones, making this a supportive, rather than primary, intervention.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Nursing interventions for calcium loss and prevention of disuse osteoporosis to guide bedside assessment, documentation, and the next nursing action.
- Nurses are instrumental in preventing 'disuse osteoporosis' by promoting early and frequent ambulation in patients, especially the elderly, post-operative patients, and those with chronic illnesses.
- Failure to promote mobility can lead to accelerated bone loss, increased fracture risk, and other complications of immobility like deep vein thrombosis and pneumonia.
- What if the patient is non-ambulatory (e.g., has paraplegia)? The principle of mechanical loading still applies. The nursing plan would shift to interventions like using a tilt table for passive standing, assisting with active or passive range-of-motion exercises, and ensuring adequate calcium and Vitamin D intake to mitigate bone loss as much as possible.
How to Approach the Question
- First, identify the core concept of the question: 'calcium loss'. In a clinical context, this often relates to bone demineralization, especially in hospitalized or less active patients.
- Next, analyze the underlying physiology. Understand that bone density is maintained by a balance of bone formation (osteoblasts) and resorption (osteoclasts). Weight-bearing stress is a primary stimulus for bone formation.
- Evaluate each option based on this physiological principle. Ask yourself, 'Which intervention most directly stimulates bone formation or prevents bone resorption?'
- Option C, 'Encourage to walk,' is a direct weight-bearing activity that stimulates bone formation.
- Compare this to other options. Option D (dairy) provides building blocks but not the stimulus. Option A (repositioning) is passive. Option B (feeds) is too general.
- Conclude that the intervention addressing the root cause of disuse-related calcium loss (lack of weight-bearing stress) is the most effective and therefore the correct answer.
Concept Tested & Keywords
- Concept Tested: Nursing interventions for calcium loss and prevention of disuse osteoporosis.
- Stem keywords: calcium loss, nursing intervention
- Lead-in keywords: What is
- Negative lead-in flag: false
Question ID
qW7C3YmNhikJ4PgYLnRmQ
Reference Book
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 101-103
E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 149-151
E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 78-80
Practise the full AIIMS Delhi NO- 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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