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NURS 2514 > Week 10 - Osteoarthritis > Flashcards

Week 10 - Osteoarthritis Flashcards

1
Q

what is arthritis

A
  • inflammation of the joint
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2
Q

what symptoms do all arthritis’ share (5)

A
  • pain
  • stiffness
  • swelling
  • redness
  • decreased ROM
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3
Q

what is the most common joint disease in NA

A
  • osteoarthritis
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4
Q

what is osteoarthritis

A
  • slowly progressive non-inflammatory disorder of synovial/diarthrodial joints
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5
Q

what is OA also referred to as (3)

A
  • “wear and tear arthritis”
  • degenerative joint disease
  • degenerative disk disease (if it occurs in the spine)
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6
Q

describe the role of inflammation in OA

A
  • inflammation is not causative

- although it can occur later, secondary to injury & synovial irritation

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7
Q

what are risk factors for OA (9)

A
  • age
  • female
  • obesity
  • immobility
  • mechanical injury
  • sports
  • repeated stress of joints
  • genetics
  • post inflammatory disorders
  • bone deformities
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8
Q

how does mechanical injury contribute to the development of OA

A
  • stimukates chondrocytes to release cytokines
  • cytokines increase the release of proteolytic enzymes = breakdown of bone & cartilage
    = loss of cartilage
    = friction within the joint increases & becomes painful to move
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9
Q

how can immobility increase the risk of OA

A
  • without joint movement, the synovial fluid becomes stagnant
    = increased friction
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10
Q

what occurs in the later stages of OA

A
  • subchondral bone (bone beneath the cartilage) responds by increasing bone production
    = creation of osteophytes (bone spurs) in the synovial space
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11
Q

what does OA most commonly affect (4)

A
  • knees
  • hips
  • lumbar & cervical vertebrae
  • hands
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12
Q

what 2 places does OA rarely affect but can after an orthopaedic injury

A
  • shoulder

- ankle

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13
Q

what are the 7 symptoms of OA

A
  • pain (range from mild discomfort to severe disability)
  • crepitus
  • spasm & decreased ROM
  • inflammation
  • referring pain
  • deformity
  • stiffness
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14
Q

describe the initial pain associated w OA (3)

A
  • achy
  • diffuse
  • stiff
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15
Q

what releives/worsens pain during the early stages

A
  • relieved by rest
  • worsened w activity
  • consistent light activity may lessen pain due to the pumping action of synovial fluid
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16
Q

describe the onset of pain during the later stages of OA

A
  • will still occur at rest

- and can disturb sleep

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17
Q

what else can worsen the pain associated w OA

A
  • cold temperature
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18
Q

what causes worsened stiffness during OA

A
  • rest (worse in the am)
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19
Q

what is crepitus

A
  • an abnormal popping or crackling sound heard in the joints
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20
Q

what causes crepitus? what makes it worse?

A
  • the breakdown of cartilage can cause bone-on-bone rub & grinding
  • appearance of osteophytes make this worse
21
Q

describe the spasms & decreased ROM during OA

A
  • deep joint pain can cause painful muscle spasms which limit the joint’s ability to move
  • ROM is also decreased due to structural changes in the joint
22
Q

what can limit the loss of & improve ROM during OA

A
  • light activity & pain management
23
Q

what causes inflammation during OA

A
  • synovial, tendon, or ligament irritation
24
Q

what are signs of inflammation during OA (4)

A
  • pain
  • warm
  • may be swollen
  • but redness rarely occurs at the knee of hips
25
Q

where might pain refer to during OA

A

may refer to:

  • groin
  • buttocks
  • sciatic region (side of knee or thigh)
26
Q

what causes referred pain during OA

A
  • OA of the neck & lower back can cause structural damage which puts pressure on the spinal nerves
    = pain radiates down the dermatome
27
Q

does OA effect joints asymetrically or symetrically

A

asymetrically

28
Q

what deformity can hip OA cause

A
  • the leg to externally rotate & flex
29
Q

what deformity can knee OA cause (2)

A
  • varus (knees bend outwards)

- valgus (knees bend inwards)

30
Q

what deformity can hand OA cause (2)

A
  • heberden’s nodes

- bouchard’s nodes

31
Q

what is heberden’s nodes

A
  • hard bony lumps in the distal interphalangeal finger joint
32
Q

what are bouchard’s notes

A
  • hard bony lumps in the proximal interphalangeal finger joints
33
Q

what are 3 ways to diagnose OA

A
  • bone scan
  • CT scan
  • MRI
34
Q

what are 7 treatments for OA

A
  • analgesics
  • exercise
  • NSAIDs
  • glucocorticoids
  • hot & cold
  • lubricants
35
Q

what is the preferred therapy for OA? why?

A
  • analgesics support (ex. tyenol)

- bc inflammation may not occur until later in the disease process

36
Q

what is the benefit of exercise during OA (4)

A
  • increases joint stability
  • prevents muscle strophy
  • pumping action may replenish synovial fluid
  • promotes weight loss in an obese pt
37
Q

what is the benefit to replenishing synovial fluid via exercise (2)

A
  • reduced friction

- improved nutrient delivery

38
Q

what is the benefit to weight loss r/t OA

A
  • decreased stress on the joint in obese pts
39
Q

when are NSAIDs used as treatment for OA

A
  • only when inflammation is present
40
Q

what is a common side effect of NSAIDs for OA

A
  • GI side effects

- but newer NSAIDs reduce this problem

41
Q

when are glucocorticoids used for OA therapy

A
  • when inflammation fails to respond to NSAID therapy
42
Q

how are glucocorticoids used for OA therapy

A
  • injections directly into the joint
43
Q

what are the limitations of glucocorticoid therapy for OA

A
  • bc of adverse catabolic effects on the joint, can only be done 4 times per joint
44
Q

when is heat used for OA (2)

A
  • during the initial stages

- to reduce stiffness

45
Q

when should heat not be used for OA

A
  • during times of inflammation
46
Q

when is cold used for OA

A
  • during times of inflammation
47
Q

what is a type of lubricant used during OA

A
  • synvisc –> synthetic joint lubricant
48
Q

what is the benefit of synvisc (3) how is it used

A

reduces:

  • inflammation
  • friction
  • pain
  • injected
49
Q

describe assessment of a pt with OA (4)

A
  • OPQRSTU
  • compare contralateral joints
  • assess for tenderness, swelling, reduced ROM, crepitation
  • consider effect on ADLs

NURS 2514 (75 decks)

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