Arthritis Flashcards
What is osteoarthritis ?
Degenerative disease of the joints
osteoarthritis is the _____ form of arthritis seen in the elderly
Number one
Which joints in the body are most affected in osteoarthritis?
Weight bearing joint knees, hips, fingers, back
What are the signs/symptoms of osteoarthritis?
Limited joint mobility
joint pain
joint stiffness
Is the pain from osteoarthritis relieved by activity or rest?
Rest
In osteoarthritis Hard nodes will develop on the joints of the fingers, creating deformities. What is this called?
Heberden’s nodes
What is the primary medication given for pain In osteoarthritis?
NSAIDs
___May be injected into the joints to treat osteoarthritis.
Corticosteroids
What should you teach the client concerning activity with osteoarthritis?
Exercise-stop of pain occurs.
Try to lose weight to help take stress of joints.
Use hot/cold beer be to help with pain.
Assistive device (Canes, braces, etc)Will help with mobility.
What surgery may be required with osteoarthritis?
Hip/knee replacement
What is Rheumatoid arthritis ?
Rheumatoid arthritis is a chronic systemic inflammatory disease that affects the joints.
Is there a particular age group that is affects Rheumatoid arthritis ?
No, it can occur at any age .
What are other clinical symptoms associated with
Rheumatoid arthritis ?
Fatigue ,
Low grade fever
Weight loss
What factor will be found in the blood of a client with Rheumatoid arthritis ? ?
Rheumatoid factor
Elevated Erythrocytes sedimentation rate
Which 5 Joint are mostly affected in Rheumatoid arthritis ??
Joints in hands , wrists, feet, elbows, shoulders
Due to inflammation of the synovial membranes, which damages cartilage, joint ___ are seen in Rheumatoid arthritis ?
Deformities
_____are the primary drug therapy in Rheumatoid arthritis ?
NSAIDs
Should you encourage this client with Rheumatoid arthritis to exercise??
Yes, activity helps the pain
What does NSAIDs stand for?
Nosteroidal antiinflmmatory drugs
What type of drugs are NSAIDs?
Aspirin and ; aspirin like drugs
What do NSAIDS do?
Reduce pain and body temp and inhibit platelet aggregation
Clients will take NSAIDS
With a full glass of ____ or milk to prevent stomach irritatation
Water
Aspirin toxicity will cause ______in the ears
Tinnitus( ringing or buzzing)
Teach clients to avoid ___ when taking NSAIDs to avoid decreased stomach irritation
Teach clients to avoid alcohol when taking NSAIDs to avoid decreased stomach irritation
How soon should a client stop taking NSAIDs for having surgery ?
1 week
Kids shouldn’t take NSAIDs How soon should a client stop taking NSAIDs for having surgery ?when they have flulike symptoms due to the risk of?
Reyes syndrome
Treatment for aspirin overdose
Activated Charcoal
Aspirin (Bayer)
What type of med is this ?
What does it treat ?
Non-opioid type
Uses-1. mild/moderate pain
2. Fever
3. * blood thinner
4. Arthritis (gout or Rheumatoid)
What are some 3 NCLEX tips for Aspirin (Bayer)?
Nclex tips-1. Do not give with anticoagulants
2. Do not give the children with flu like symptoms because of Reye syndrome
3. Stop taking one week before surgery
Acetaminophen (Tylenol)
What type of med is this ?
What does it 4 treat ?
Non-opioid type
Uses-1. mild/moderate pain
2. Fever
3. Decrease inflammation
4. Arthritis (gout or Rheumatoid)
Acetaminophen (Tylenol) can cause ___ so don’t give to what type of client ?
What is the antidote ?
What are signs of overdose?
Non-opioid type
Nclex tips—1. can cause liver toxicity
2. Do not give to liver failure or renal failure patients
3. Antidote is Acetylcysteine ( A-seat-toe-sis-stean
Overdose signs-Weak pulse with cold and clammy skin
Naproxen (Aleve)
What type of med is this ?
What does it treat ?
Non-opioid type
Uses-1. mild/moderate pain
2. Fever
3. Decrease inflammation
4. Arthritis (gout or Rheumatoid)
What are some NCLEX tips for Naproxen (Aleve)?
What should you take with this med and why ?
Why should you check the stool for And why ?
Nclex tips-take with food; We will cause G.I. ulcers/bleeding
-check for black stool because the is a Sign of internal bleeding
NASIDs(Motrin, ibuprofen)
What type of med is this ?
What does it treat ?
What are some NCLEX tips ?
Non-opioid type
Uses-1. mild/moderate pain
2. Fever
3. * blood thinner
4. Arthritis (gout or Rheumatoid)
NCLEX tips for NSAIDs?
What should you take with this med and why ?
Do not take NSAIDs with __?
And stop taking _____ before surgery?
It cause what 2 things ?
Nclex tips-1. take with; food will cause G.I. ulcers
2. Do not take NSAID and aspirins together
3. Stop taking one week before surgery
Can cause ototoxicity and photosensitivity
Morphine
What type of med is this ?
If the respiration’s are below 10 what do you do and why?
Do you watch for?
What can happen with long term use ?
Opioids/Narcotic type
-Hold if respirations are below 12;
will cause respiratory depression
- watch for constipation
Addict may occur with long term use
hydromorphone (Dilaudid)
What type of med is this ?
What will this cause?
Opioids/Narcotic type
- Reduce respirations
-This is not morphine;
you can’t interchange them
-This is many more times stronger than morphine
Codeine
What type of med is this ?
What is used for ?
Take it with ___and why?
Opioid/Narcotic type
- Used as a cough suppressant
- Take with food to prevent nausea/vomiting
(Demerol) meperidine hcl
What type of drug is this ?
Don’t give this to which client and why ?
Opioid/Narcotic type
-Do not give to patient with head injuries; can increase intracranial pressure
Percocet (oxycodone)
What type of med is this ?
What does it have in it? so it safe to give to what client?
Percodan has what in it ?
Opioid/Narcotic type
- Has Tylenol In it; okay to give if allergic to aspirin
- Percodan has aspirin In it instead of Tylenol ; do not give if patient is allergic
What side do your hold the cane on ?
What Leg do you advance with first ?
Cane =COAL-=Cane Opposite Affected Leg
You advance with the bad leg first then the Good Leg follows
Canes-
The cane moves with the _bad leg but is on the strong side.
Then the __good leg follows.
Coal= cane opposite affected leg
The top of the crutches should be ?
When the handgrip is properly placed, the angle of elbow flexion will be ____?
Do not let the _crutch press into __the armpit .
2-3 finger widths below anterior anxillary fold to a
point lateral to and slightly in front of foot
When the handgrip is properly placed, the angle of elbow flexion will be 30 degrees
How do you go up the stairs with crutches or canes?
Stair walking with Crutches or cane
Stairs- Up 1st w/__good leg, then __bad legs w/crutches
Down 1st _bad leg w/crutches, then __good leg follows__.
Again, up with the good and down with the bad!!!
Walkers
How do you use a walker ?
If they must tie belongings to the walker where do you tie them ?
Pick it up, set it down, walk to it
If they must tie belongings to the walker; have
them tie it to the side & not the front (can tip over); no wheels/tennis balls (per boards!)
Walkers-
Never try to use __________ or ______________.
Elbows flexed at ______ to _____degrees. Same measurements as cane.
Step first with ______ leg then follow with ________
leg.
Do not ______ _ ________________when walking.
Walkers-
Never try to use ___stairs or _ escalators.
Elbows flexed at __20 to _30 degrees. Same measurements as cane.
Step first with ____bad leg then follow with good
leg.
Do not _pick the walker up when walking.
How do you do 2 point gait ?
2-Point Gait
i. Step One: Move one crutch and opposite foot together
ii. Step Two: Move other crutch and other foot together
iii. Remember: 2 points together for a 2 point gait
iv. Examples: one knee replacement
How do you do 3 point gait ?
3-Point Gait
i. Step One: Move two crutches and bad leg together
ii. Step Two: move good foot by self
iii. Remember: 3 point is called 3 point because three points
touch down at once
iv. Examples: Stairs
How do you do 4 point gait ?
4-Point Gait
i. Step One: One crutch
ii. Step Two: Opposite foot
iii. Step Three: Other Crutch
iv. Step Four: Other food
v. Examples: total both knee right after surgery
How do you do swing through?
Who is swing through for ?
Swing- through: . NON-weight bearing.. amputations plant the crutches & swing through
i. Examples:
When to use each gait ?
Even for even an odd for odd
a. Use the even numbered gaits (2&4 point) when weakness is evenly distributed (bilateral). Two point for mild problem; four-point for severe problem
b. Use the odd numbered gait (3 point) when one leg is odd
(unilateral problem)
Which gait would you use for a left above knee amputee:
Swing through
Which gait would you use for a 1st day post op R knee replacement; partial weight bearing allowed
3
Which gait would you use for a advanced stages:
4
Which gait would you use for a left hip replacement; 2nd day post op non weight bearing
Swing through
Which gait would you use for a bilateral knee replacement
4
Which gait would you use for a bilateral total knee; 3 weeks post op:
2
Promoting Circulation
1.)Thromboembolic Compression (TED) holes -you put them on your_____
What do you need know abt Sequential Compression device?
What do you need to monitor with Sequential Compression device?
U need an order for both of these and found out the size by measuring the calf
Clients are NOT ALLOWED TO:
- 3.
1.)Thromboembolic Compression (TED) holes -you put them on your patient before they get out of bed
2.)Sequential Compression device-_____
What are these attach to what ?
When need to monitor what ? And why ? How do you check this ?
2.)Sequential Compression device-Machines that are promoting circulation by putting force gradually on and off the patients leg.
Know the right size these are attached to a pump
so monitor your patient skin integrity make sure the pump is not applying too much forced to your patient ( by checking Leg indentations )
U need an order for both of these and found out the size by measuring the calf
Clients are NOT ALLOWED TO:
- Cross their legs
- Sit for long periods of time
- Put pillow behind the knees
What do you need for both TED/sequential compression device ?
How do you find out the size ?
Clients are not allowed to do what ?
U need an order for both of these and found out the size by measuring the calf
Clients are NOT ALLOWED TO:
- Cross their legs
- Sit for long periods of time
- Put pillow behind the knees
