Infection and Inflammation Flashcards
N201
What is osteoarthritis (OA)?
Slow progressive noninflammatory disorder of the diarthrodial (synovial) joints.
Think wear and tear
Etiology & Pathophysiology of OA
-gradual loss or destruction of articular cartilage.
-Cartilage become weak & dull.
-Formation of osteophytes occur.
Main cause of OA?
-No single cause.
-Caused by an event or condition which leads to joint instability.
What can cause OA?
-Drugs (e.g. indomethacin & corticosteroids)
-Hematologic/ endocrine (e.g. chronic hemarthrosis)
-Joint instability
-Mechanical stress (e.g. sports)
-Neuro problems (e.g. diabetic neuropathy)
-Skeletal deformities (e.g. broken hip)
-Trauma
Risk factors for OA?
-Age
-Decreased estrogen increases the risk in women.
-Obesity
-Anterior cruciate ligament (ACL) , injury from sports.
-Work (constant kneeling & stooping)
Regular moderate exercise decreases risk
Clinical manifestation of joint pain (OA).
-NO SYSTEMIC MANIFESTATIONS!
-Joint pain (main symptom)
-Joint stiffness
-Crepitation
-Affects asymmetrically
-Deformities
Joint pain with OA typically goes away with rest? true or false?
-True
-Typically occurs in the morning, but resolves in 30 mins.
-This is what distinguishes it from RA.
What can happen with OA affecting joints asymmetrically?
-One limb will initially be affected.
-Strong limb will over compensate.
-The strong limb becomes more susceptible.
Cold therapy pt. teaching…
-For inflammation
-Cover source w/ towel or cloth.
-Keep off areas w/ radiation, open wounds, & poor circulation.
- If it’s not possible to apply directly to site, try above or below or opposite side of body on corresponding site.
Heat therapy pt. teaching…
-For stiffness
-Cover source w/ towel or cloth.
-Keep off areas w/ radiation, decreased sensation, or injury within 24 hrs.
-Don’t use w/ menthol products.
What are the deformities with OA?
-HEBEDEN NODES: “distal” (DIP Joint)
-BOUCHARD’S NODES: “Proximal” (PIP Joint)
-Knee: bowleg, knock- kneed
-Hip: One leg shorter
What does care of OA focus on?
-PAIN MANAGEMENT
-PAIN MEDS
-No cure
-NSAIDS ARE 1ST LINE OF DEFENSE
What’s one MAJOR safety measure for a pt. with OA?
-FALL RISK
-TEACH STAIR SAFETY, USE HANDRAILS OF LIVE IN ONE STORY.
What is Rheumatoid Arthritis?
-Chronic, systemic autoimmune disease.
-CHARACTERIZED BY INFLAMMATION OF CONNECTIVE TISSUE in the diarthrodial (synovial joints).
What test is primarily looked at for RA?
-ERYTHROCYTE SEDIMENTATION RATE (ESR)
What are the clinical manifestations of RA?
-Pain
-Stiffness
-Limited motion
-Signs of inflammation
-OCCURS SYMMETRICALLY
What does synovial fluid look like in RA?
-CLOUDY, STRAW-COLORED FLUID, W/ FIBRIN FLECUS, & INCREASED WBCs IN THE FLUID.
What’s the preferred drug for early treatment with RA?
METHOTREXATE
What should we monitor when using Methotrexate?
-HEAPATOTOXICITY, ALT/AST before and during treatment!
-INFECTION, MONITOR CBC!
-PREGNACY! MUST HAVE NEGATIVE PREGNACY TEST!
what’s the normal ALT & AST for the liver?
ALT: 7 - 56 (u/l)
AST: 5 - 40 (u/l)
What is systemic lupus erythematosus (Lupus)?
Autoimmune disease that effects multiple systems & organs.
2 Cardio complications with lupus.
-Pericarditis = inflammation of the pericardium.
-Myocarditis = inflammation of the heart muscle.
One MAJOR complication of Lupus?
ANTIPHOSPHOLIPID SYNDROME (causes blood clots)!!!
What’s the MOST SERIOUS from an upper GI bleed?
SUDDEN ONSET OF SEVERE ABDOMINAL PAIN!!!!
What is a Mallory-Weiss tear (GI bleed)? & what is the CAUSE?
-Tear in mucous membrane or inner lining where the esophagus meets the stomach.
-CAUSED BY > forceful vomiting or retching (dry heaving).
What happens when the GI tract absorbs blood?
BUN INCREASES!
TYPING/ CROSS MATCHING in UGI bleed is important to have because…..
-this will help you be prepared for POSSIBLE BLOOD TRANSFUSIONS!
What to MONITOR for those @ risk for HYPOVOLEMIC SHOCK? (UGI bleed)
-BP (ORTHOSTATIC HYPOTENSION)
-SKIN (PALLOR, COLD, CLAMMY)
-along with other signs…
Nursing care if pt. is in hypovolemic shock & kidneys are not being perfused? (UGI bleed)
INSERT AN INDWELLING URINARY CATHETER!
Why HEMODYNAMIC MONITORING for UGI bleeds?
To check blood circulation & evaluate how well the heart is working.
cholelithiasis Vs. cholecystitis
cholelithiasis = stones in gallbladder.
cholecystitis = inflammation of gallbladder wall.
Clinical manifestations of cholecystitis (RUQ)?
Pain may be referred to the right shoulder or scapula.
DARK AMBER TO BROWN URINE WHICH FOAMS…
this occurs b/c bilirubin can’t reach the intestines when the common bile duct is obstructed.
STEATORRHEA
Undigested fat because the bile in not reaching the intestines.
What is ERCP?
-endoscopic retrograde cholangiopancreatography.
-used for gallbladder and/ or the pancreas.
