Gerontology- Test 2

Front 1

What is osteoarthritis?

Back 1

DJD, degenerative joint disease. progressive deterioration and loss of cartilage and bone

Front 2

What is rheumatoid arthritis?

Back 2

Inflamatory disease- chronic- inflamatory changes in joints (primarily synovial).
synovitis

Front 3

Etiology or 5 factors effecting osteoarthritis

Back 3

age genetics obesity trauma occupation- post menopausal; lack of exersize

Front 4

Etiology or 6 factors effecting rheumatoid arthritis

Back 4

1.autoimmune 2genetic 3female rep.hormones 4virus 5 stress; 6 chemicals: nicotine and caffiene

Front 5

what is diagnostic test for osteoarth.?

Back 5

x-ray

Front 6

what is diagnostic test for rheumatoid arthritis? (6)

Back 6

x-ray, RF, ANA, ESR, cbc Arthrocentesis.

Front 7

What is RF test for?

Back 7

rheumatoid factor- measures presence of unusual antibodies

Front 8

what is ANA?

Back 8

antinuclear antibody test- measure titer of unusual antibodies that destroy nuclei of cells

Front 9

what is ESR?

Back 9

confirms inflammation test for rheuma. arthritis

Front 10

what can cbc confirm?

Back 10

anemia

Front 11

what is test that samples synovial fluid and relieves pressure?

Back 11

arthrocentesis

Front 12

what are clinical manifestations of oseoarthritis? (3)

Back 12

pain- worse w/use better w/rest; stiffness joints; joint changes-enlargement due to bony hypertrophy

Front 13

what joint changes are associated with osteoarthritis?

Back 13

heberdens nodes, crepetis, unilateral pain, no inflamation.

Front 14

what are the early manifestations of rheumatoid arthritis?

Back 14

fatigue weakness stiffness anorexia persistant low fever
joint inflam- pip and mcp
bilateral, symmetrical progresses in # of joints

Front 15

late manifestations of rheumatoid arthritis?

Back 15

joint deformity
swan neck or ulnar deviation
bouchard nodes

Front 16

what are bouchard nodes vs herberden nodes?

Back 16

both reactive bony overgrowth with oseo and rheumatoid arth. bouchard proximal herberden distal

Front 17

pain in spine related to pressure from rheumatoid arthritis?

Back 17

rabiculapathies- compression of spine press on nerves

Front 18

late manifestations of rheumatoid arth?

Back 18

osteoporosis, subcutaneous nodules, periperal neuropathy,pericarditis, vasculitis, sjogrens disease, renal disease pulmonary complications

Front 19

what is sjorgrens syndrome?

Back 19

glands stop secreteing- dry syndrome

Front 20

What is first line drug for osteo arth

Back 20

tylenol and nonsalicylates- aspirin, buff. aspirin w/ meals

Front 21

what is NSAID? examples.

Back 21

non steroidal anti inflamm. drug.; aleve motrin naprosin

Front 22

prob with nsaids

Back 22

cause sodium retention
better pain control intervention if hyper tension or kidney disorder; nervous system issues disorient and head aches; gi bleeding

Front 23

name 2 synthetic joint fluid implants for oseo arth

Back 23

hyaluronic and synvisc

Front 24

name 2 muscle relaxants for osteo arth

Back 24

flexeril and robaxin

Front 25

topical prep for osteo arth

Back 25

capsaicin

Front 26

what is last resort drug relief for oseot arth?

Back 26

steroid injections

Front 27

non pharmalogical relief for osteo arth?

Back 27

rest; thermal modality- moist heat if not diabetic, cold only for inflam.; positioning

Front 28

what does TENS tx do?

Back 28

diverts attention from pain

Front 29

diet should be?

Back 29

night veges; tomatoes, eggplant

Front 30

surgery contraindications?

Back 30

infection, inflammation or osteoporosis; recoup is 8 weeks

Front 31

Hip replacement post operative procedures?

Back 31

prevent dislocation- subluxation- keep legs abducted prevent flexion 90 degrees. turn as ordered

Front 32

assessment for dislocation?

Back 32

increased pain; shortening of extremity rotation of extremity (**in is out)

Front 33

prevent deep vein thrombosis and pulmonary embolis

Back 33

a) venodyne boots b) leg exersize c)red,swell, pain
d)neurovascular assess e)anticoagulents

Front 34

what anticoagulants might be given after surg?

Back 34

hep. injection- sub cut
lovenox- coumadin bld tests
aspirin- 6-12 mo

Front 35

what is activity progression?

Back 35

1 day bed rest; 2nd day movement and walking

Front 36

what will prevent atrophy of muscle

Back 36

continuous passive movement and knee imobilizer to extend at bed time

Front 37

7 classifications of drugs used for rheumatoid artheritis

Back 37

1.salicylates 2 nsaid 3. cytotoxic 4. gold salts 5. minocycline 6 corticosteroids 7 remicade.

Front 38

name cytotoxic drug and describe and why used

Back 38

methotrexate: 1x week
casues pcp; mouth sore;dyspnea; liver inflam;bone marrow suppression

Front 39

name 2 gold salts

Back 39

myochrisine- injectable
ridaura

Front 40

which rheumatoid arthritis drug do you have to monitor cbc and urine?

Back 40

gold salts

Front 41

what are side effects of gold salts?

Back 41

takes 3-6 mos to work; protienurea, mouth ulcer, skin rash anemia and pain; diarrhea nv

Front 42

what is minocycline?

Back 42

rheum arht; immune modifier: anitmicrobial and anti inflammatory lower side effects: not as effective

Front 43

corticosteroid side effects

Back 43

DM, infection, fluid and electrolyte imbalance, glaucoma

Front 44

what is nursing intervention for cytotoxic drug side effect

Back 44

magic mouth wash- mylanta and benedryl: avoid citris, spice and caffeine: no vaseline on wound

Front 45

what is gout?

Back 45

systemic disease; urate crystals deposit in joints and other body tissues; infamation

Front 46

describe 2 types of gout:

Back 46

primary- production of uric acid exceeds excretion- genetics-middle age or older
Secondary-excessive uric acid due to renal insufficiency, diuretics, chemo- all ages

Front 47

what are 4 phases of gout?

Back 47

asymptomatic hyperuricemia- serum level increases
acute- painful inflamation in small joints
intercritical- remission
chronic- after repeated episodes, can feelcrystals under skin and in organs

Front 48

what are manifestations of gout?

Back 48

acute- painful joints
chronic- tophi- papules- destroy cartilage
renal stones

Front 49

why was it called rich mans disease?

Back 49

wealthy kings ate foods like shell fish, game meats organ meats etc..

Front 50

How is it diagnosed?

Back 50

ESR, serum uric acid up, urine uric acid up, kidney tests, arthrocentesis

Front 51

Signs and symptoms of gout

Back 51

hot and red

Front 52

medications for acute gout:

Back 52

colchine- decreases deposit.5 mg evert hour until pain alleviated
NSAID- indomethacine; pain and inflammation

Front 53

medications for chronic gout:

Back 53

allopurinal(zyloprim)- inhibits enzyme 3xweek
probenecid- increases secretion of uric acid 250 bid-500bid
colbenemid- mix of 2 above

Front 54

what should be avoided if gout present?

Back 54

aspirin and diuretics, alcohol, no fasting, low purine stress

Front 55

what should be encouraged if gout is present?

Back 55

water intake, fruit juices, alkaline ash diet, citris