Rheumatic 1 Flashcards
Rheumatic disease
Arthritis refers fo inflammation of a joint
Rheumatic diseases affect primarily the bones and muscles but also the joints
Classification of rheumatic disease
Monoarticular or polyarticular
Inflammatory or non-inflammatory
Osteoarthritis
Is a joint disorder characterised by slowly progressive non-inflammatory changes to the synovial joints
Degenerative bone disease
New joint forma in response to cartilage destruction
Moat common form of joint disease in Australia
Oa type
Idiopathic (primary)
Secondary oa cause of trauma , mechanical stress, specific medications
Oa pathophysiology
Cartilage damage triggers metabolic response
Progression causes the cartilage to become softer, less elastic, and more susceptible to wear with heavy use
Eventually fissures develop and erosion occurs resulting in reduced motion
Oa risk factors
Increased age Obesity Previous joint pain Repetitive use Anatomic deformity Genetic susceptibility
Oa symptoms
Stiffness Pain upon movement Pain gradually worsens with joint use Pain affected by barometric changes Decreased morbidity Creptitation Weight bearing joints
Oa medical management
Rest and joint protection Heat and cold application Nutritional therapy and exercise Drug therapy Weight reduction Use if orthotic devices
Oa pharmacological management
Topical agents Paracetamol Salicylates Cox-2 inhibitors Corticosteroids opioids
Surgical management
Repair cartilage
joint replacement
Oa nursing management
Pain due to disease process
Impaired physical mobility Related to limitations
Reduced self care ability to decrease activity
Mood alteration due to discomfort and reduced mobility
Oa preparation for discharge
Quality of life is largely dependent upon the severity of the patient’s disease and the pain they are experiencing
Adjustments to home
Mobility aids
Arthritis support groups
Rheumatoid arthritis
Chronic systemic inflammatory disease that affects the connective tissue in the synovial joints
Autoimmune
Characterised by exacerbation and remission periods
Ra clinical manifestation
Fatigue anorexia
Joint stiffness
Swelling
Deformity of hands
Ra collaborative care
Multidisciplinary team can include physician, nurse, physiotherapist and occupational therapist
Nutrional counselling Drug therapy Implants Complimentary therapy Heat and cold application
Ra pharmacological therapy
Pain relief and reduce inflammatory Non-steroidal anti-inflammatory med Disease-modifying anti-rheumatic drugs(dmards) Biological dmards Other
Pain relief and reduce inflammatory response
Analgesia
Corticosteroids
Non-steroidal anti-inflammatory
Salicyte
Non-salicyte
Disease-modifying anti-rheumatic drugs
Methotrexate
Sulfasalazine
Biological dmards
Stop immune system from attacking joints
Tumour necrosis
Other receptor antagonist
Other
Gold compound
Antibiotics
Penicillamine
Lifestyle medicine
Nutrition
Maintaining mobility or activity
Nutrition
Correct anorexia, weight loss and anaemia
Emphasis on foods high in protein, iron and vitamins
Omega 3
Eating utensils adapted to suit patients
Maintaining or Increasing mobility
Rest Heat and cold packs Exercise Surgical procedure Strengthening muscles
Gout
Caused by increased of uric acid production
Under excretion of uric acid by the kidneys or increased intake of foods containing purines
Gout primarily affects
Men between 40-50
Older people with diuretics
Types of gout
Primary :90% of cases. Caused by overproduction or retention of uric acid
Secondary gout: caused by drugs that inhibit uric acid excretion or increased rate of death of cells
Gout symptoms
Attacks usually at night - awakened by severe pain, redness, swelling, warmth of affected joint
Usually Recurring
Gout diagnosis
Serum uric acid levels
Joint aspiration
Gout medication
Colchicine
Probenecid
Allopurinol
Nsaids
Colchicine
Colgout lowers deposition of uric acid and reduces inflammation
Probenecid
Increases urinary excretion of uric acid
Allopurinol
Interrupts breakdown of purines before uric acid
Gout nursing care
Education regarding consumption of food high in purines and alcohol intake, maintenance of normal body intake, pain management during episode
Monitor side effects of medications
