Module 3 Flashcards
Ch. 11, 12, 20
Osteoarthritis - pathophysiology
Changes within the joint
Unilateral
NOT systemic
Osteoarthritis - clinical manifestations
Progressive pain that increases with joint use
Decreased ROM
Tender to touch joints
Bony Swelling
Soft tissue swelling, deformity, instability, crepitus
More pain with activity, pain improves with rest
Heberden’s Node + Bouchard
Osteoarthritis - assessment
Unsteady gait
Fatigue
Elevated serum creatinine (NSAID use)
Elevated liver enzymes
Multiple medication use
Vital signs
Osteoarthritis - hypothesis (potential client problems)
Pain
Sleep issues
Difficulty caring for self due to pain
Decreased ROM
Osteoarthritis - nursing actions
Give medications: Acetaminophen (NSAIDS)
Cold packs
Heating pad
Osteoarthritis - teaching
Prescribed medications
PT/OT
Referral to orthopedic sx
Home health referral
Osteoarthritis - evaluation
ADLs
Pain goal met
Rheumatoid Arthritis - pathphysiology
Chronic systemic autoimmune disease
Bilateral
SYSTEMIC (fever, anemia, malaise, loss of appetite)
Rheumatoid Arthritis - clinical manifestations
Joint pain/swelling
Erythema
Morning stiffness
Fatigue
Joint deformity - Swan Neck, Boutonniere, Ulnar deviation
Rheumatoid Arthritis - assessment
Unsteady gait
Increased infection
Elevated creatinine/liver enzyme
Fatigue
Rheumatoid Arthritis - hypothesis (potential client problems)
Pain
Difficulty sleeping/caring for self
Decreased ROM
Mobility issues
Rheumatoid Arthritis - nursing assessment
Labs - CRP/ESR, liver/renal function
Rheumatoid Arthritis - nursing actions
Give medications (analgesics, NSAIDS, DMARDS, glucocorticoids)
Frequent rest periods
Rheumatoid Arthritis - teaching
Treatment plan
Reporting s/s of infection
Immunosuppressive therapy discontinued if active infection
Keeping up with vaccinations
Scleroderma - pathophysiology
Affects skin/organs, autoimmune disease, systemic
Scleroderma - clinical manifestations
Thickened hardened skin
Digital ulcers
HTN
Heartburn
Dysphagia
Cough
Pain
Scleroderma - assessment
Head to toe assessment - disease affects all major organs
Scleroderma - teaching
Disease processes, protecting skin from trauma
Lupus - pathophysiology
Autoimmune disease, affects every organ
Lupus - clinical manifestations
Vague/diverse manifestations
Butterfly rash across cheeks
Lupus - labs
ESP, CRP, ANA, may be elevated with SLE
Lupus - medications
Plaquenil (most common)
NSAIDS
Glucocorticoids
Immunosuppressive agents
Lupus - nursing assessment
Give medications
Head to toe assessment
Monitor labs - BUN and creatinine, urinalysis, CBC, CRP/ESR
Lupus - hypothesis (potential client problems)
Fatigue
Self-image challenges
Altered skin integrity
Lupus - nursing actions
Administer analgesics and anti-inflammatory medications
Lupus - teaching
Treatment plan/disease process
Use sunscreen daily
Keep immunizations UTD
Avoid oral contraceptives
Lupus - evaluation
Medication compliance, pain goal met, able to carry out ADLs
Gout - pathophysiology
Uric acid build up in joints, bone, soft tissue caused by inflammation
Gout - clinical manifestations/assessment
Severe joint pain (big toe)
Tophi in chronic gout
Lab values - elevated uric acid
Swelling, redness, warmth over affect joint
Decreased ROM
Gout - hypothesis (potential client problems)
Pain, lack of knowledge
Gout - nursing actions
Give uric acid lowering agents, analgesics and steroids
Gout - teaching
Avoid foods/drinks high in purines, avoid alcohol (eps. beer), red meat, liver, fish, report flare ups
Gout - evaluation
Elimination of gout flare-ups and prevent joint destruction
Fibromyalgia -pathophsyiology
Chronic pain disorder
Fibromyalgia - clinical manifestations/assessment
Insomnia
Fatigue
Stiffness
Cognitive dysfunction
Anxiety
Fibromyalgia - hypothsis
Chronic pain
Ineffective coping skills
Depression/anxiety
Fibromyalgia - nursing actions
NSAIDS
Antidepressants
Antiseizure
Heat/cold therapy
