The nurse is writing a care plan for a client with symptomatic Paget’s disease. Which of the following interventions should be included to help the patient's symptoms?


• Paget disease of bone, also known as osteitis deformans, is a disorder of bone metabolism that is characterized by an accelerated rate of bone remodeling, resulting in overgrowth of bone at selected sites and impaired integrity of the bone. Many patients with Paget disease of bone are asymptomatic.

• The two main clinical manifestations are pain and deformities in affected areas, but fractures, bone tumors, neurologic disease, cardiac disease, and abnormalities in calcium and phosphate balance can also occur.

• Alendronate is an antiresorptive agent that targets the osteoclast, which is considered the primary cell responsible for Paget disease, suppressing bone resorption. After a course of treatment, bone turnover indices such as alkaline phosphatase return to normal in 60% to 70% of clients.

• Oral analgesia and heat therapy can provide pain relief in symptomatic Paget's.

• Bone scans are the most efficient means of identifying pagetic bone. This is important when diagnosing the client but will not help treat the client’s complaints related to the complications of the disease.

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