F - Wk9 Osteoarthritis

Question 1

What’s osteoarthritis?

Answer 1

1. degenerative joint disease
2. chronic, non-inflammatory condition caused by gradual wear and tear of joint cartilage & underlying bone after inadequate repair
3. most common type of arthritis

Question 2

What’s the main cause & risk factors for osteoarthritis?

Answer 2

1. daily stress applied to synovial joints throughout an individual’s lifetime
   - especially to weight-bearing joints like hip, knee & ankles

Risk factors:
1. age, especially after 50 years + obesity, joint overuse or injury
- altered walking patterns
- can increase joint stress

2. family history of osteoarthritis
3. female
4. having associated medical conditions
   - metabolic disorders like diabetes
   - neurologic disorders like multiple sclerosis
   - hematologic disorders like sickle cell disease

Question 3

Whats the pathology of osteoarthritis?

Answer 3

1. articular cartilage wears away from repetitive stress -> weaker + loses elasticity
2. cartilage has limited repair capacity -> areas of maximal stress start developing fibrillations = cracks/clefts on what used to be a smooth articular surface
3. over time, cartilage will continue to erode away until the underlying bones are exposed -> allow them to rub against each other
4. At the same time, on the joint edges, bone reacts by growing outward at the margins -> osteophytes / bony spurs

Question 4

What are the symptoms of osteoarthritis?

Answer 4

1. joint pain
   - early stages of the disease, pain tends to worsen with activity
   - worsens in the evening
   - over time clients may experience pain with slight motion / even at rest
   - Sometimes can get worse with weather changes
2. joint stiffness with limited ROM
   - often worst in the morning
   - usually up to 30 minutes
   - improves with activity as the joint warms up

3 joint swelling or instability
- harder to perform daily activities

4. osteophytes might be visible as single subcutaneous nodules over the affected joints

Question 5

How do you diagnose osteoarthritis? idt will test

Answer 5

1. history and physical assessment,
2. X-rays of the affected joints
   - confirm diagnosis by showing cartilage loss & narrowing of joint space
3. blood tests
   - to rule out other types of arthritis & to reveal associated medical conditions causing osteoarthritis
4. arthrocentesis
   - to evaluate synovial fluid and rule out other types of arthritis
   - in osteoarthritis synovial fluid is usually clear & no signs of inflammation

Question 6

Whats the treatment for osteoarthritis?

Answer 6

• joint damage in osteoarthritis can’t be reversed but treatment can stop its progression, mitigate some symptoms & improve QOL

1. lifestyle modifications
   - weight-loss, moderate exercise
   - physical therapy, range of motion exercises & local muscle strengthening
   - important when large weight-bearing joints like the hips and knees are affected
2. For joint instability
   - joint can be immobilized and protected using supportive or orthotic devices like braces & splints
3. pharmacological treatment: symptomatic
   - reduce pain by using oral analgesics
   - NSAIDs and acetaminophen, topical capsaicin, or weak opioids like tramadol
4. If none of these treatment options are successful: surgery
   - total joint arthroplasty / total joint replacement
   - osteotomy: bones cut & realigned to relieve pressure & pain

Question 7

What’s the nursing care you’ll provide for a client with osteoarthritis?

Answer 7

Aim: Decrease client’s symptoms, promote joint health & function & improve QOL

1. Mobility assessment
   - Evaluate for joint enlargement or swelling, stiffness, crepitus, and range of motion
2. Assess joint pain by asking about onset, quality, severity, relieving or aggravating factors & duration of pain
3. Apply heat pack to the affected area
   - for joint pain or instability
   - assist to immobilize joint with splint or brace until inflammation subsides