Osteoarthritis/Test 4 Flashcards

1
Q

Osteoarthritis is

A

a progressive non-inflammatory disease that affects joints and surrounding tissues. No single cause has been identified.

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2
Q

Modifiable risk factor for osteoarthritis:

A

Obesity- moderate exercise and weight control has been shown to decrease the likelihood of disease development and progression.

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3
Q

Cartilage destruction can begin between ages

A

20 and 30. More than half >65 years have xray evidence in at least one joint.
-before age 50, men affected more than women. Incidence greater in women after age 50

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4
Q

Etiology and Pathophysiology-

A

*OA results from cartilage damage and narrowing of the joint space

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5
Q

No significant inflammatory component but

A

synovial fluid may become inflamed from cartilage and bone erosion- loss of cartilage and body cannot repair cartilage because of ongoing destruction. Known to involve formation of new joint tissue in response to cartilage destruction

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6
Q

Etiology and pathophysiology- cartilage and bony growth

A

increase at joint margins. Resulting incongruity in joint surfaces. Contributes to reduction in motion.

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7
Q

Pain

A
  • inflammatory change contributes to early pain and stiffness.
  • later in disease pain results from contact between exposed bony joint surfaces after articular cartilage has completely deteriorated.
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8
Q

Types and causes: Idiopathic (Primary)

A
  • etiology unknown

- age is factor (wear and tear on joints)

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9
Q

Secondary

A

any condition that damages cartilage-
*Obesity, athletics, dancing, performing repetitive actions and infections. (Trauma, mechanical stress, inflammation, joint instability, neurologic disorders, skeletal deformities, hematologic/endocrine disorders and use of selected drugs)

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10
Q

Prevention is not

A

possible. Community education should focus on- alteration of modifiable risk factors, weight loss, occupational and recreational hazards.
* Athletic instruction and physical fitness program safety measures

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11
Q

Nursing assessment:

A
  • Type
  • location
  • severity
  • and duration of pt’s joint pain and stiffness.
  • questions on extent these symptoms affect abilities to perform ADLs
  • pain relieving practices
  • physical exam of affected joints (tenderness, swelling, limitation of movement, crepitation). Compare to the unaffected side.
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12
Q

Systemic S/S:

A

None!!!

  • fatigue, fever, organ involvement are not present in OA
  • important distinction between OA and inflammatory joint disorders such as RA
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13
Q

Nursing Implementation/Acute intervention:

A
  • Usually treated on an outpatient basis

- health assessment questionnaires are often used to pinpoint areas of difficulty

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14
Q

Frequent complaints of OA patients-

A
  • pain
  • stiffness
  • limitation of function
  • frustration of coping with physical difficulties on a daily basis
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15
Q

Clinical manifestations of joints:

A
  • most commonly involved joints.
  • joints of fingers, weight bearing joints (hips, knees), metatarsophalangeal (MTP) joint of foot, cervical and lower lumbar vertebrae
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16
Q

Nursing Assessment-Joints

A
  • asymmetrical- joint pain is predominant symptom- ranging from mild discomfort to significant disability and loss of function.
  • pain worsens with joint use- early stages: rest relieves pain. Later stages- pain and rest and sleep is disturbed because of pain and increased joint discomfort.
  • Bones worse as barometric pressure decrease.
  • pain may be referred to groin, buttock, or medial side of thigh or knee.
  • Sitting down becomes difficult, as does getting up from a chair when hips are lower than knees.
  • Joint stiffness occurs after periods of rest or static position- early morning stiffness usually resolves within 30 minutes. Overactivity can cause mild joint effusion, temporarily increase stiffness.
17
Q

Nursing assessment: deformity-Knee

A

OA often leads to joint malalignment- result of cartilage loss in medical compartment. Bowlegged appearance, altered gait, and crepitation (in 90%)

18
Q

Nursing assessment deformity- Hip

A

*Advanced hip OA may cause one leg to be shorter

19
Q

Nursing assessment deformity- Hand’s

A
  • Heberden’s nodes-DIP joints
  • Bouchard’s nodes- PIP joints- deformity : red, swollen, tender nodules. Does not cause significant loss of fx. Visible disfigurement can be distressing can appear as early as age 40. Tends to be seen in family members.
20
Q

Diagnostic studies:

A
  • In early OA tests- detect joint changes on bone scan, computed tomography (CT) scan, magnetic resonance imaging (MRI)
  • In progressed OA- xray findings: will show joint space narrowing, bony sclerosis & osteophyte formation.
  • Changes do not always correlate with degree of pain patient is experiencing
  • No lab abnormalities are a specific diagnostic indicator of OA- serological and synovial fluid examination will be essentially normal
21
Q

Non pharmacologic interventions:

A
  • managing pain and inflammation
  • preventing disability
  • maintaining and improving joint function
  • achieve independence in self care and maintain optimal role function
  • use pharmacologic strategies as an adjunct to manage pain