Which of the following clients are at risk for developing osteomalacia? Select all that apply

Question

A) An elderly female who "can't stand to drink milk" and refuses calcium supplements since she has a history of kidney stones
B) A person who lives in a colder region of the northwest who doesn't get out much during the winter months for fear of falling
C) A middle-aged adult with acute renal insufficiency caused by decreased cardiac output prior to having a coronary bypass graft surgery
D) A young 30-year-old African American diagnosed with hypertension who is noncompliant related to taking medication and prescribed diet restrictions
E) A female client whose father had a genetic predisposition to primary hyperparathyroidism resulting in increased calcium resorption from the bone

Answer 1

Ans: A, B, E
Feedback:
In contrast to osteoporosis (which causes a loss of total bone mass), osteomalacia causes defective mineralization but not the loss of bone matrix. The incidence of osteomalacia is high among the elderly because of diets deficient in calcium and vitamin D. Melanin is extremely efficient in absorbing UVB radiation; thus, decreased skin pigmentation markedly reduces vitamin D synthesis. There also is a greater incidence of osteomalacia in the colder regions of the world, particularly during the winter months when UVB radiation is inadequate to allow skin synthesis of vitamin D. Acute renal insufficiency and uncontrolled hypertension do not relate to defective bone mineralization.