title: Role of the nurse in preserving patients' independence.
abstract: OBJECTIVE
  Patients with metastatic bone disease may be treated with bisphosphonates to reduce or delay skeletal complications including pathologic fracture, radiotherapy to bone, and hypercalcemia of malignancy. Nurses can provide important education to patients and support or encourage the use of bisphosphonates throughout therapy.
  
  
  METHODS
  Literature and congress reports were reviewed for relevant efficacy information on bisphosphonates and adverse events that may occur during bisphosphonate therapy. Bisphosphonates can provide meaningful benefits to patients, and zoledronic acid is now approved for the treatment of bone metastases secondary to any solid tumor.
  
  
  RESULTS
  To optimize care, nurses can monitor pain scores, changes in mobility, adverse events, and serum creatinine levels. A useful tool for recording these parameters is a patient diary. The nurse should fill out the diary at each patient visit and compare it with baseline information before treatment is administered. Patients should also be counseled on the importance of adequate hydration, good dental hygiene, the need for calcium and vitamin D supplements, and how to best manage potential side effects.
  
  
  CONCLUSIONS
  Bisphosphonates are effective in reducing and delaying skeletal complications, and zoledronic acid has demonstrated significant efficacy in preventing skeletal complications across a wide range of solid tumors and multiple myeloma. Nurses play an important role in enabling patients to optimize bisphosphonate therapy and in supporting patients to continue treatment to preserve their functional independence.
authors.affiliation: Advanced Medical Specialties, 8940 N. Kendall Drive, Suite 300 East Tower, Miami, FL 33176, USA. ca.eck@elsevier.com
authors.forename: Cathy
authors.initials: C
authors.lastname: Maxwell
mesh_terms: D000203:Activities of Daily Living; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000451:nursing / Q000556:secondary; D004164:Diphosphonates / Q000627:therapeutic use*; D004282:Documentation; D016903:Drug Monitoring; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology / Q000517:prevention & control; D007093:Imidazoles / Q000627:therapeutic use*; D024802:Nurse's Role; D009730:Nursing Assessment; D009737:Nursing Records; D009859:Oncology Nursing / Q000458:organization & administration; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010349:Patient Compliance; D010353:Patient Education as Topic; D012944:Social Support; D016896:Treatment Outcome; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid