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CARE OF CLIENTS WITH PROBLEMS IN COORDINATION > Joint Disorder (Osteoarthritis & Rheumatoid Arthritis > Flashcards

Joint Disorder (Osteoarthritis & Rheumatoid Arthritis Flashcards

1
Q

a slowly progressive non-inflammatory disorder of the synovial joint

A

Osteoarthritis

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2
Q

Expected to increase greatly as the population ages

A

Osteoarthritis

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3
Q

More common in elderly

A

Osteoarthritis

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4
Q

What is osteoarthritis?

A
  • a slowly progressive noninflammatory disorder of the synovial joint
  • Expected to increase greatly as the population ages
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5
Q

Causes of osteoarthritis

A

-medications (stimulate collagen; corticosteroids)
- inflammation
-diabetic neuropathy
-joint instability
-trauma

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6
Q

digesting enzymes in joint synovium

A

stimulate collagen

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7
Q

what is stimulate collagen

A

digesting enzymes in joint synovium

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8
Q

Pathophysiology of osteoarthritis

A

-aging (cartilage destruction)
-genetics
-decreased estrogen at menopause
- obesity
-occupational

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9
Q

describe the type of occupational that could lead to osteoarthritis

A

job that require frequent kneeling

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10
Q

Clinical Manifestations of Osteoarthritis (specifically joints )

A

-joint pain
-pain with rest or sleep (advanced)
-joint stiffness

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11
Q

joint pain occurs in

A

-groin
-buttock
-outside of the thigh or knee

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12
Q

After periods of rest or static position

A

joint stiffness

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13
Q

joint stiffness resolves within

A

joint stiffness relieves within 30 minutes

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14
Q

grating sensation due to lose particles of cartilage

A

crepitation

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15
Q

What is joint stiffness

A

-after periods of rest or static position
-resolves within 30 minutes
-crepitation

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16
Q

what are the 2 nodes in the clinical manifestations of osteoarthritis

A

-Heberden’s nodes
-Bouchard’s nodes

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17
Q

distal interphalangeal (DIP) joints

A

Heberden’s nodes

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18
Q

due to osteophyte formation and loss of joint space

A

Heberden’s nodes

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19
Q

Describe the heberden’s nodes

A

-distal interphalangeal (DIP) joints
-due to osteophyte formation and loss of joint space

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20
Q

proximal interphalangeal (PIP) joints

A

Bouchard’s nodes

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21
Q

Describe the Bouchard’s nodes

A

proximal interphalangeal (PIP) joints

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22
Q

What’s the difference between heberden’s nodes and bouchard’s nodes

A

Heberden’s nodes is distal interphalangeal joints while the bouchard’s nodes is proximal interphalangeal joints

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23
Q

Diagnostics of osteoarthritis

A

-Bone scan
-MRI
-CT Scan
-ESR

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24
Q

What are the management of osteoarthritis?

A

-Rest and joint protection
-Heat and cold application
- Nutritional therapy & exercise

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25
Q

Rest and joint protection in the management of osteoarthritis

A

not more than a week to prevent stiffness

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26
Q

Heat and cold application in the management of osteoarthritis

A

-cold for acute inflammation
- heat therapy for stiffness

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27
Q

Nutritional therapy in the management of osteoarthritis

A

-weight control
- movement therapies (yoga, tai chi)

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28
Q

Surgical management of osteoarthritis

A

Reconstructive joint surgery

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29
Q

Medical Management of Osteoarthritis

A

-Aspirin
- Capsaicin cream
-NSAIDS
- Acetaminophen
- Opioids
- Disease Modifying Osteoarthritis Drugs (DMOADs)

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30
Q

it prolonged bleeding time

A

Aspirin

31
Q

it blocks pain

A

Capsaicin cream

32
Q

risk for bleeding/GI irritations

A

NSAIDS

33
Q

Slow the progression of osteoarthritis or support join healing

A

Disease modifying osteoarthritis drugs

34
Q

Purpose of aspirin in osteoarthritis

A

prolonged bleeding time

35
Q

Purpose of capsaicin cream in osteoarthritis

A

blocks pain

36
Q

example of NSAIDS drugs in osteoarthritis

A

Diclofenac/Misoprostol (Arthrotec)

37
Q

Mechanism of action of disease modifying osteoarthritis drugs

A

slow the progression of osteoarthritis or support joint healing

38
Q

chronic, systemic autoimmune disease

A

rheumatoid arthritis

39
Q

inflammation of connective tissue in the diarthrodial (synovial) joints

A

rheumatoid arthritis

40
Q

marked by periods of remission and exacerbation

A

rheumatoid arthritis

41
Q

increases with age, peaking between ages 30 and 50

A

rheumatoid arthritis

42
Q

What is rheumatoid arthritis

A

-chronic, systemic autoimmune disease
-inflammation of connective tissue in the diarthrodial (synovial) joints
-marked by periods of remission and exacerbation
-increases with age, peaking between ages 30 and 50

43
Q

etiology of rheumatoid arthritis

A

-idiopathic
-autoimmune
-combination of genetics and environmental triggers

44
Q

what triggers the combination of genetics and environmental in the rheumatoid arthritis

A

-smoking
-genetics

45
Q

pathophysiology of rheumatoid arthritis

A

AUTOIMMUNE ETIOLOGY
-presence of autoantibodies (rheumatoid factor) against this abnormal IgG
-autoantibodies combine with IgG to form immune complexes that deposit on synovial membranes
-activates inflammatory response
-neutrophils release proteolytic enzymes
-causes damage articular cartilage and thickening of synovial lining

46
Q

Clinical Manifestations of Rheumatoid Arthritis

A

-joint pain & inflammation
-limitation of motion
- occurs symmetrically
- affect the small joints of the hands and feet
-stiffness after activity
-morning stiffness
-ulnar drift (zigzag deformity)
-swan neck deformity
- boutonniere deformity
-Hallux Valgus

47
Q

last from 60 minutes to several hours or more

A

morning stiffness

48
Q

describe the characteristics of morning stiffness

A

morning stiffness last from 60 minutes to several hours or more

49
Q

toe deformity

A

Hallux Valgus

50
Q

What is Hallux Valgus

A

toe deformity

51
Q

Also known as zigzag deformity

A

ulnar drift

52
Q

Types that affect the small joints of the hands and feet

A

-proximal interphalangeal (PIP)
-metacarpophalangeal (MCP)
-metatarsophalangeal (MTP)

53
Q

Diagnosis of Rheumatoid Arthritis

A

-CBC count
- History and physical findings
-Erythrocyte Sedimentation Rate
-Rheumatoid Factor
-Synovial fluid analysis

54
Q

Reveals a slightly cloudy, straw colored fluid

A

Synovial fluid analysis

55
Q

Purpose of Synovial fluid analysis

A

Reveals a slightly cloudy, straw colored fluid

56
Q

What are the types of disease-modifying antirheumatic drugs

A

-Methotrexate
-Corticosteroids
-NSAIDS

57
Q

Purpose of disease-modifying antirheumatic drugs

A

-immunosuppressants
-decrease risk for joint erosion and deformity

58
Q

what is disease-modifying antirheumatic drugs?

A

immunosuppressants and decrease risk for joint erosion and deformity

59
Q

has lower risk for toxicity

A

methotrexate

60
Q

What is methotrexate?

A

-has lower risk for toxicity
-requires frequent laboratory monitoring
- can be given with other DMARDs

61
Q

for symptom control; pain and inflammation

A

corticosteroids

62
Q

this drug is for pain & inflammation

A

NSAIDs

63
Q

Purpose of corticosteroids in DMADs

A

for symptom control; pain & inflammation

64
Q

Corticosteroids is given in ___

A

intra-articular injections

65
Q

Surgical Management of Rheumatoid Arthritis

A

-Synovectomy
-Arthroplasty

66
Q

Removal of the inflamed joint tissue (synovium)

A

Synovectomy

67
Q

Done using Arthroscopy

A

Synovectomy

68
Q

What is Synovectomy

A

-Removal of the inflamed joint tissue (synovium)
-done using arthroscopy

69
Q

Total joint replacement

A

Arthroplasty

70
Q

Removal of the worn-out or damaged parts of joint and replaced with an artificial joint (prosthesis)

A

Arthroplasty

71
Q

What is Arthroplasty?

A

-Total joint replacement
- Removal of the worn-out or damaged parts of joint and replaced with an artificial joint (prosthesis)

72
Q

Nursing Management of Rheumatoid Arthritis

A

PROTECTION OF SMALL JOINTS
-maintain joint in a neutral position to minimize deformity
-use the strongest joint available for any task
-distribute weight over many joints instead of stressing a few
-change positions frequently.

73
Q

How to distribute weight over many joints instead of stressing a few

A

-slide objects instead of lifting them
- hold packages close to the body for support

74
Q

what is crepitation

A

grating sensation due to lose particles of cartilage

CARE OF CLIENTS WITH PROBLEMS IN COORDINATION (4 decks)

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