A patient who has several risk factors for osteoporosis has a bone density test that indicates osteopenia.The primary care NP plans to prescribe a bisphosphonate.Before initiating treatment,the NP should:

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Patients must have adequate nutrition,calcium,and vitamin D.Hypocalcemia and vitamin D deficiency must be corrected before therapy is initiated.An upper GI x-ray is indicated only if the patient is symptomatic.Patients at risk for fracture should not take PPIs.Calcium and vitamin D supplements should be given with bisphosphonate therapy; however,the first action is to evaluate current serum levels.

A Patient Who Has Several Risk Factors for Osteoporosis Has