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NSG 320 (mcp) > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

Osteoarthritis

A

Degenerative Joint Disease

Most common form of arthritis

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2
Q

Osteoarthritis most commonly affects which joints?

A

hips, knees, spine, hands

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3
Q

Osteoarthritis pathophysiology

A

progressive deterioration of cartilage
Formation of boney spurs (osteophytes) due to increased osteoblast activity.
Results in pain, immobility, muscle spasms, and potential inflammation.

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4
Q

Primary causes of Osteoarthritis:

A
  1. Aging

2. Genetics

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5
Q

Secondary causes of Osteoarthritis:

A
  1. Joint injury
    - occupational
    - repetitive exercise
  2. Obesity
  3. Trauma
  4. Overuse
  5. Diseases
    - Paget’s Disease
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6
Q

Describe the Pain associated with Osteoarthritis

A

Chronic Joint pain and stiffness
Diminishes after rest
Worsens after activity

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7
Q

Describe the Range of Motion associated with Osteoarthritis

A

May be limited
Pain with movement

Atrophy of skeletal muscles
Limp

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8
Q

Describe what you might see in the joints related to Osteoarthritis

A 
Enlarged, hardened joints
Crepitus may be present 
Secondary synovitis (inflammation of synovial membrane)
Heberden’s Nodes
Bouchard’s Nodes
Joint effusions
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9
Q

What might you see in the hands that is indicative of Osteoarthritis?

A

Heberden’s Nodes (distal phalanges)

Bouchard’s Nodes (proximal phalanges)

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10
Q

How is Osteoarthritis diagnosed?

A
  1. History

2. Physical examination

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11
Q

What other diagnostic tests can be used to help diagnose Osteoarthritis?

A
  1. X-ray: may show degenerative changes
  2. MRI and CT for vertebral bones and knees
  3. ESR and CRP can identify synovitis
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12
Q

What is the biggest Nursing intervention for Osteoarthritis?

A

Pain management!

  • Tylenol, NSAIDs
  • Lidoderm patches
  • Topical NSAIDs & other topical meds
  • Muscle relaxants
  • Opioids (LAST RESORT! Not a LT fix)
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13
Q

Name some other interventions for Osteoarthritis

A
  1. Exercise and rest balance
  2. Hot and cold therapy (focus on heat)
  3. Weight control
  4. Supplements
  5. Positioning
  6. Shoes (supportive)
  7. Surgery
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14
Q

Exercise for Patients with Osteoarthritis

A

Swimming, Walking, Cycling, Swimming, Aerobics
Exercise consistently; Active exercises are more beneficial than passive
On days when pain is increased, attempt exercise, but reduce the number of repetitions and avoid resistance exercises

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15
Q

What supplements can be taken for Osteoarthritis?

A

Glucosamine
Chondroitin
CBD oil (per Messer)

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16
Q

Positioning for Osteoarthritis

A

Maintain joints in functional positions
Good posture when standing
Proper weight distribution
Use a small pillow under the head and neck while lying down, but don’t prop joints in a flexed position

17
Q

Curative remedies & Osteoarthritis

A

Warn patients about “curative” remedies, and instruct them to talk with their provider before trying any new therapies

18
Q

Surgery for Osteoarthritis

A

Total joint arthroplasty/replacement
-Surgical creation of a joint
Most common: Hips and Knees

Hips: acetabular + femoral component
Knees: femoral + tibial component

19
Q

When is Surgery indicated for Osteoarthritis?

A

Indicated only when QOL can no longer be maintained

-Majority of patients are >60

20
Q

Contraindications for Joint Arthroplasty

A
  1. Infection
  2. Advanced osteoporosis (bone can shatter)
  3. Severe inflammation
21
Q

Cemented Hip Joint Arthroplasty

A

Weight-bearing
-Can perform weight-bearing immediately post-op

Mostly used in older adult patients because it wears down over time

22
Q

Press-fitted Hip Joint Arthroplasty

A

Non-weight-bearing
-CAN’T perform weight-bearing immediately post-op

Relies on bone growth

23
Q

Patient Education for Joint Arthroplasty

A
  1. NPO status
  2. Pre-op Antibiotics
  3. Dental work + antibiotics
    - pts with hip replacements need PPx Abs
  4. Positioning/Restrictions
24
Q

What is the most important assessment post-surgical?

A 
CMS  Assessment (Neurovascular assessment!!)
  -compare operative leg to non-operative leg

Circulation: color, temp., distal pulses, capillary refill
Movement: can they wiggle their toes?
Sensations: can they feel it? paralysis? pain?

25
Q

Hip Joint Arthroplasty Complications (5):

A
  1. Dislocation
  2. DVT/ PE** (HIGH RISK!)
  3. Infection
  4. Bleeding (hypotension)
  5. Neurovascular Compromise
26
Q

What are the 3 Signs of a Hip Dislocation?

A
  1. Severe pain (sudden, intense)
    - sudden agitation for pts unable to communicate
  2. Shortening of the leg
  3. Leg rotation
27
Q

Hip Precautions:

A

LOOK FOR PT NOTES OR TALK TO PT!!

  1. Maintain correct positioning of hip joint & leg at all times
    - Supine with head slightly elevated
    - Keep legs abducted with pillows
  2. Maintain knees and back at a 90-degree angle when sitting.
  3. DON’T cross or rotate legs while sitting or standing
  4. DON’T bend forward to pick up objects
  5. Loosen straps on abduction devices every 2 hrs and assess for skin irritation/breakdown.

(pg. 1009)

28
Q

Why do we use an Abduction pillow?

A

To keep the legs apart and prevent adduction, especially for older adult patients that are restless or have a decreased LOC

29
Q

When do we use an Abduction pillow?

A

For patients who had a posterior approach (posterolateral or direct lateral approach) hip arthroplasty

30
Q

Knee Arthroplasty Post-op Interventions

A
  1. Continuous Passive Motion machine
    - settings ordered by a provider
  2. Ice
  3. Pressure dressing
  4. Positioning
31
Q

Positioning considerations for a Knee Arthroplasty

A

Prevention of adduction is not necessary**
Keep in a neutral position
-avoid hyperextension and rotation

NSG 320 (mcp) (24 decks)

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