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41 Cards in this Set
- Front
- Back
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What type of arthritis causes the degeneration of joint surfaces char by erosion of articular cartilage?
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Osteoarthritis
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Joint pain that improves with rest, swelling and joint enlargement and decreased range of motion are indicative of?
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Osteoarthritis
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Non pharmacoogic management of osteoarthritis includes:
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Weight loss to reduce stress on joints, PT to increase ROM and muscle strength, OT to promote joint protection and energy conservation
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What is the first pharmacological approach to mild to moderate osteoarthritis?
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Acetominophen (remember: this is not an anti inflammatory)- used for pain
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What is the purpose of giving acetominophen to someone with osteoarthritis?
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Decrease pain to allow them to continue activity and movement within a full range of motion.
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When is a surgical consult made for a patient with osteoarthritis?
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When their pain cannot be controlled by acetominophen/NSAID's or Opiates.
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Arthroscopic debridement is effective for how long?
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This procedure's effects last for 4-5 years and it involves trimming the rough edges of cartilage.
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Arthroplasty involves what type of arthritis treatment?
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Total Joint replacement
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Osteotomy uses what rationale for treatment of osteoarthritis?
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Osteotomy cuts out a wedge of bone to redistribute the weight and lessen the pain
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Arthrodesis results in what level of range of motion?
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Eliminated, because this procedures fuses two joints together.
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9 Principles of Joint Protection
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1. do gentle ROM daily
2. Adjust your activity level according to your pain level 3. Make an effort to maintain your ideal weight 4. Pace yourself by balancing rest and activity 5. Use assistive devices to preserve your joints 6. Use the largest or strongest joint possible when doing a specific task 7. Avoid excessive pressure to stress on the small joints of the hand 8. Change positions as often as possible 9. Extend your joints as opposed to contracting them |
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What type of arthritis affects 3X more women than men?
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Rheumatoid
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What type of arthritis has an onset between 30 and 50 years of age?
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Rheumatoid
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What causes the tissue damage in rheumatoid arthritis?
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It is an autoimmune response. Tissue is daamged by the body attacking its own cells.
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What is a hallmark sign of rheumatoid arthritis?
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Bilateral damage to joints. Eg, if the joint in the middle finger hurts on one side, it also is affected on the other side.
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What three classes of drugs are used to treat rheumatoid arthritis?
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1. NSAID's
2. Corticosteroids 3. DMARDS- remittive agents or Disease Modifying Anti-Rheumatic Drugs. |
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What affect to prostaglandins have when present in the joints?
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inflammation and pain
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How do corticosteroids treat rheumatoid arthritis?
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Corticosteroids act as an inflammatory and as an immunoregulator
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When is a DMARD used?
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DMARD's are used when persistent disease activity is established. Not a first line of defense.
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What class of drugs has been shown to alter the disease course and improve radiographic outcomes for rheumatoid arthritis?
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DMARD's
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What drug used for rheumatoid arthritis was initially approved as an anti-cancer drug?
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methotrexate, a DMARD
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What is the onset of actions for one of the fastest acting DMARD's, methotrexate?
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4-6 weeks
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What is important to consider when starting a client on methotrexate?
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They must continue taking their NSAID's until the DMARD kicks in (can be two months.
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What is one possible contraindication to giving a DMARD?
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Liver disease, or any co morbidity or the lung, liver, or bone marrow. DMARD's can cause toxicity in compromised organs.
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How do DMARD's work?
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They interrupt the cytokine TNF (tumor necrosis factor) and alter the destruction of cells.
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What is apoptosis?
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Programmed cell death. Cytokines like TNF tell cells when they should lyse themselves. This occurs in adults 50-80 billion times per day. It is a part of the cycle of cells regenerating. In cancer and in rheumatoid arthritis, this process gets out of control and the body destroys itself.
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At what age does osteoarthritis typically occur?
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40+
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Redness, warmth, and swelling of joints is more often associated with which kind of arthritis?
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Rheumatoid
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What type of arthritis is likely to affect shoulders and elbows?
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Rheumatoid
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What type of arthritis causes a general feeling of sickness, fatigue, weight loss and fever
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Rheumatoid
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What can cause a decrease in bone marrow?
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DMARDs
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What can cause septic arthritis of the knee?
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MRSA or plain staph. treated by injecting antibiotics into the knee or sucking the bad stuff out
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What causes gout?
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build up of uric acid crystals.
May be trigged by use of hydrochlorothiazide diuretics. |
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What is a major symptom of gout?
Treatment? |
extreme pain
Treatment includes rest, diet, meds, and ice. Coffee helps it (even decaf) and dark fruits also help. |
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What are risk factors for osteomylitis?
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diabetes, hemodialysis, drug abuse and splenectomy
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How is osteomylitis detected?
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This infection in the bone causes pain, swelling, fever, malaise, purulent drainage.
It can be detected by a bone scan, CBC (elevated WBC and elevated sedimentation rate, blood cultures, MRI with aspiration and biopsy. Osteomylitis can be caused by TB |
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Osteosarcoma is
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malignant progress in bone. Usually requires amputation
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Post op nursing care includes?
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-vitals signs
-pain management -infection prophylaxis -monitored activity -DVT prophylaxis -anticoagulants -monitor HCT and Hbg -pt and family education |
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Pagets Disease occurs when?
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Osteoblasts and osteoclasts work together dysfunctionally. Typically occurs after a person is grown, involves bone growing more than it should and irregularly . Treated with calcitronin to inhibit bone reabsorption
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Rickets is the result of a deficiency of what?
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Vitamin D.
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Adults with vitamin D deficiencies develop what?
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osteomalacia
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