management of rheumatic disorders (4) Flashcards
is rheumatoid arthritis chronic or acute
chronic
what is the etiology of rheumatoid arthritis?
autoimmune, unknown etiology
what are risk factors of RA
smoking, genetics, viral or bacterial illness
RA is when the immune system attacks___________
the synovial lining of joints
when inflammation thickens the synovium and destroys joint, its called ________
pannus formation
what are labs/tests for RA
arthrocentesis
CT
CBC, ESR, CRP, rheumatoid factor (inflamm)
what meds are avoided in RA?
opioids
what meds are used for RA
-DMARDS (disease modifying anti-rheumatic drugs)
-NSAIDS (ibuprofen/naproxen)
-cox-2 (celecoxib)
-corticosteroids (prednisone)
complications of RA
-CVD
-med toxicity
-damage to skin/eyes/vessels/heart etc.
-deformity of hands/feet
goals of RA treatment
-decrease pain / swelling, prevent joint damage, minimize disability
what is involved in RA treatment
exercise, nonpharm methods, tai chi yoga, complimentary alternative medicine
what is noninflammatory joint destruction and is an end result of an autoimmune disorder
osteoarthritis
what is osteoarthritis caused by
obesity, laborous occupation, genetics
what condition has breakdown of articular cartilage, progressive damage to bone, narrowing of joint space, joint movement limited, pain/damage, progressive joint damage
osteoarthritis
what is osteoarthritis aggravated and relieved by?
aggravate = movement/exercise
relieve = rest
lab/tests for OA
xray/MRI
blood test to r/o RA
meds that can help OA
NSAIDS
cox-2 (celecoxib)
intra-articular corticosteroids
acetaminophen
diclofenac
glucosamine / chondroitin
complications of osteoarthritis
-depression / sleep disturbances
-difficulty with ADLs
-need for arthroplasty
how can nurses help OA
exercise/strength training
weight loss
OT/PT
splints/braces
CAM therapy
heat/cold
what are causes of gout?
-high uric acid in blood
-age, BMI
-HTN meds
-thiazide diuretics
what causes high uric acid in blood
-fructose beverages
-alcohol (beer)
what happens in gout?
-hyperuricemia
-macrophages crystallize (sharp/painful)
-deposits in peripheral area
how will a client with gout present?
-arthritis
-sudden pain
-pain, swelling, tender
-limited ROM
labs/tests for gout
joint fluid analysis
xray
what meds help acute gout attacks
colchicine
NSAIDs
corticosteroids
meds for management of gout
xanthines (allopurinol)
uricosurics (probenecid)
what are complications of gout
-tophi (nodules)
-kidney stones
how can nurses help gout pts?
-foods low in purines (organ meat)
-have coffee, vit. C, and cherries
-lifestyle change
-weight loss
-decrease alcohol
-med compliance
what is amplified pain d/t CNS abnormally amplifying pain signals
fibromyalgia
what are causes of fibromyalgia?
unknown
what triggers fibromyalgia
genetics, anxiety, depression, trauma
how will a client with fibromyalgia present?
-widespread pain
-fatigue
what labs/tests are for finromyalgia
none
what meds help fibromyalgia
NOT OPIOIDS
-NSAIDS
-TCAs!!!
-SNRIs/SSRIs!!
-muscle relaxants
how can nurses help fibromyalgia?
CAM/exercise
CBT
sleep hygeine
support group
stress reduction
