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OA Exam 2 > OA Osteoarthritis > Flashcards

OA Osteoarthritis Flashcards

1
Q

Osteoarthritis

A
  • DJD (Degenerative Joint Disease)
  • Non-inflammatory disorder of mobile joints
  • Characterized by breakdown in cartilage
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2
Q

Osteoarthritis is the most common…

A

form of joint disease in US

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3
Q

Most significant risk factor for osteoarthritis

A

age

-normal process of aging due to wear and tear on joint

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4
Q

Percentage of affected adults by osteoarthritis

A

greater than 90% by age 40

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5
Q

What gender is more affected by osteoarthritis after age 50

A

women are more affected after 50

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6
Q

How many people are symptomatic over 65 years old?

A

60%

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7
Q

Types of Osteoarthritis

A
  1. Primary

2. Secondary

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8
Q

Primary Osteoarthritis

A
  • idiopathic (no known cause)

- localized vs. general

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9
Q

Secondary Osteoarthritis

A

-identifiable cause or predisposition

  • repetitive movement
  • physical stress
  • obesity
  • certain occupations
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10
Q

What gender is more affected by osteoarthritis before 45

A

men more affected before 45

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11
Q

Male osteoarthritis differences

A
  • more affected before 45
  • knee OA is more common before 45
  • Hip OA is more common after 55
  • Hip, Knee, spine
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12
Q

Female osteoarthritis differences

A
  • affected twice as often as men after 45
  • knee OA more common after 45
  • joints in fingers and thumb base more common after 55
  • Hip, knee, hands
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13
Q

Describe cartilage during osteoarthritis

A
  • damaged
  • dull, yellow, and granular
  • thins/erodes
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14
Q

What happens to the joint during osteoarthritis?

A
  • deteriorates
  • spurs develop at joint margins
  • joint anatomy changes
  • interferes with function, decreases mobility
  • underlying bone is exposed
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15
Q

Prevention of OA

A
  • maintain ideal weight
  • control blood sugar
  • regular moderate exercise
  • maintain proper posture
  • maintain body alignment
  • rest when discomfort noted
  • seek treatment early
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16
Q

Diagnostic Studies for OA

A
  • xray
  • MRI
  • Bone Scan
  • CT
  • ESR
  • Fluid aspiration
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17
Q

What do xrays show for OA patients?

A
  • joint narrowing

- spurs

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18
Q

Joint fluid aspirate is used to detect…

A
  • presence of bacteria (infection)

- uric acid crystals (gout)

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19
Q

Nursing assessment

A
  • fam hx
  • OLDCARTS-P
  • pain
  • activity level
  • mobility
  • physical apperance
  • dx tests
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20
Q

OLDCARTS-P

A
  • onset
  • location
  • duration
  • character
  • aggravating/relieving
  • radiation
  • timing
  • severity
  • prior
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21
Q

Nursing diagnoses

A
  • chronic pain
  • impaired physical mobility
  • sedentary lifestyle
  • imbalanced nutrition
  • dressing self care deficit
22
Q

Implementation of nursing process

A
  • decrease pain
  • increase mobility
  • encourage weight loss
  • assistive device
23
Q

evaluation of nursing process

A
  • routine assessment

- monitor changes

24
Q

Management of osteoarthritis

A
  • no cure
  • interdisciplinary
  • control of pain and inflammation
  • prevention of disability
  • improvement of joint function
25
Q

Non-invasive management

A
  • rest and joint protection
  • heat for stiffness
  • ice for acute exacerbation
  • weight reduction
  • complimentary/homeopathic therapies
  • PT
26
Q

complimentary/homeopathic therapies

A
  • acupuncture
  • yoga
  • massage
  • glucosamine and condroitin
27
Q

PT for osteoarthritis

A

increases strength and flexibility

28
Q

Pharm therapies for mild to moderate pain

A

Non-opioid analgesics

  • NSAIDs
  • Topical gels/cream
29
Q

Typical non-opioid analgesics cream for OA

A

Capsalcin cream

30
Q

Pharm therapies for moderate to severe pain

A
  • Salicylates
  • NSAIDs
  • Corticosteroids
  • Opioid Analgesics
31
Q

Major joints for surgical intervention

A

hips and knees

32
Q

Purpose of surgery for OA

A
  • improves function
  • corrects deformity
  • remove damage
  • relieves pain
33
Q

Types of surgery

A
  • joint arthroplasty
  • joint resurfacing
  • joint irrigation
  • joint fusion
  • osteotomy
34
Q

Cemented Hip Arthroplasty (HA)

A

bonds bone to bone

-can become loose and require revision

35
Q

Cementless Hip Arthroplasty (HA)

A

long-term stability

-for patient with high activity level and life expectancy >25 yrs

36
Q

Risks of Hip Arthroplasty

A
  • infection
  • clots
  • joint breakdown
37
Q

Pre-op nursing care for Total Hip Arthroplasty

A
  • establish data base
  • reassurance regarding pain relief
  • explain and practice post-op activities
  • PT consult
  • Fit for support hose
38
Q

how to establish data base

A

amount of pain and disability

39
Q

post-op activities

A
  • turn, cough, and deep breathe
  • isometric exercises of quads and glutes
  • dorsiflexion and plantar flexion of foot
40
Q

isometric exercises

A

no joint movement

41
Q

PT consult

A
  • use of trapeze

- exercises

42
Q

Support hose for THA patients

A
  • helps prevention for thrombophlebitis
  • wear for 6-8 wks
  • use along with anticoagulants
43
Q

Post-op nursing care for THA

A
  • take measures to prevent infection
  • assess dressing, drainage tubes, and VS
  • early ambulation
  • maintain correct positioning
  • watch for signs of dislocation
44
Q

Measures to prevent infection after THA

A
  • educate client about S/S of infection
  • antibiotics after new joint
  • prophylactic antibiotics before dental procedure
  • strict asepsis during dressing change and when emptying any drains
45
Q

Assessing the dressing & drainage tubes

A
  • expect 200-500cc drainage in 1st 24 hrs

- expect 120cc by 48 hrs

46
Q

Early ambulation after THA

A
  • 1st post op day
  • with walker and PT for cemented
  • partial weight bearing for non-cemented
47
Q

Correct positioning for post-op THA

A
  • do not cross legs
  • no adduction or rotation
  • hip flexion not to exceed 90 degree for 4-6 weeks
  • turn toward unaffected side/use brace
  • help with socks and shoes
  • use elevated toilet seat
48
Q

Signs for dislocation

A
  • groin pain on movement

- deformity or external rotation

49
Q

Total Knee Arthroplasty (TKA)

A

replacement of knee joint due to unremitting pain and/or instability of joint

50
Q

Pre and Post op care for TKA

A

-similar to THA except do not use abduction pillow or brace

51
Q

Post-op care for TKA

A

-(CPM) Continuous passive motion machine

52
Q

CPM

A
  • range per minute ordered by surgeon
  • 8-20 hrs/day
  • prevents scar tissue
  • positioned incorrectly can cause damage

OA Exam 2 (6 decks)

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