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3.4 - ABSN NUR 405 Musculoskeletal & Arthritis > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

Osteoarthritis is characterized under rheumatic disorders as a what?

A

Local joint disorder with localized inflammation

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2
Q

T/F Osteoarthritis is progressive and patients will become more symptomatic over time

A

True

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3
Q

T/F Osteoarthritis shows systemic manifestations

A

False, OA involves a low level of inflammation at the local joint, and involves formation of new joint tissue in response to cartilage destruction

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4
Q

Is OA a normal part of the aging process

A

NO

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5
Q

What is one of the first medications given with OA

A

Tylenol

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6
Q

Osteophytes are also known as

A

Bone spurs due to excess bone growth

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7
Q

Age when symptoms start with OA

A

usually after 40

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8
Q

commonly affected body parts in OA

A

Lumbar and cervical spine

joint at base of thmb

knuckles and tips of fingers

hip

knee

joint in foot above the heel

knuckle at the base of big toe

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9
Q

LESS commonly affected body parts in OA

A

shoulder

wrist

elbow

knuckles at base of fingers

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10
Q

symptoms of OA

A

pain

stiffness

crackling or clicking in joints

extra bone growth

decreased Range of motion

problems in joint alignment

tenderness

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11
Q

OA Clinical manifestations

A

No systemic Cues

Joint pain (Most common reason for medical attention)

  • Worsens with use
  • Relieved by rest
  • Change in temperature or barometric pressure
Pain
- worse with activity
Stiffness
- worse with inactivity
- More common in the AM; resolves within 30 min

Crepitus
- typically asymmetrical

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12
Q

Finer deformities in OA

A

Heberden’s nodes - most distal joint on fingers

Bouchard’s nodes - more proximal on fingers

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13
Q

knee deformities in OA

A

Bowlegged appearance

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14
Q

3 tests that show early joint changes and can diagnose OA

A

Bone scan

CT

MRI

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15
Q

Test helpful in staging progression

A

X-Ray

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16
Q

What can an X-Ray help show in OA

A

Joint narrowing

bony sclerosis (bone thickening)

osteophyte formation (bone spurs)

17
Q

T/F Xray does not correlate to degree of pain

A

True

18
Q

Are there biomarkers for OA?

A

No

19
Q

What will the ESR value be if there is no synovitis present

A

ESR will be normal

20
Q

What color would the synovial fluid be in someone with OA

A

Clear yellow with no signs of inflammation

21
Q

What are 5 nursing problems we see in OA

A

Acute and/or chronic pain

Impaired physical mobility

self-care deficit

Imbalance in nutrition : More intake than required

Depression r/t chronic pain

22
Q

What do we want to do to understand a patient’s baseline for pain in OA

A

multidimensional pain assessment to get a baseline

23
Q

Non drug intervetions for OA relating to joint protection

A

Rest/Joint protection

  • maintain functional position with orthotics
  • avoid prolonged immobilization
  • use assistive devices ( canes, walkers, chair lift)

Weight reduction prn and aerobic exercise

24
Q

OA drug therapy mild-mod

A

acetaminophen - if lacking s/s of inflammation

  • 3 gm daily
  • 4 gm if limited duration or medically supervised
  • MONITOR LFT’s
25
Q

OA drug therapy if unrelieved w tylenol or s/s of inflammation

A

NSAIDs

  • monitor bleeding
  • ulcer
  • GI upset
  • Renal issues
26
Q

OA drug therapy if GI side effects a problem

A

Cox-2 inhibitor (celecoxib)

27
Q

What topical creams can be use in treatment of OA

A

NSAIDs or capsaicin (active ingredient - chili peppers)

28
Q

2 types of joint injections in OA

A

Glucocorticoid (steroid) injections

Hyaluronate injections

29
Q

What do we use steroid injections for

A 
suppress inflammation
and
if unrelieved by other measures
and 
Arthritis confined to a few joints
30
Q

Are steroid injections permenant or temporary relief

A

temporary; may experience brief flare up after injection

31
Q

What are patients at risk for with injections

A

risk for injection

if injected frequently can cause joint damage
- no more than 3-4 a year

32
Q

what do Hyaluronate injections do

A

substance in joints that allows joint fluid to be slippery

33
Q

What is hyaluronate injections typically reserved for

A

those awaiting joint replacement (knee, in particular)

34
Q

What are 4 of the interdisciplinary teams that can help with OA

A

Rheumatologist
PT
OT
nutritionist

35
Q

What is important with home management of OA

A

Family/support system

36
Q

Non drug complementary interventions for OA

A
  • yoga
  • acupuncture, biofeedback
  • Glucosamine/chondroitin (OTC, no evidence to support, can give 6-month trial)
37
Q

Non drug interventions for OA r/t heat and cold therapy

A

Heat/cold application

  • heat can decrease stiffness (20min on/20 min off)
  • hot packs
  • paraffin wax bath
  • whirlpool

3.4 - ABSN NUR 405 Musculoskeletal & Arthritis (10 decks)

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