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55 Cards in this Set

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What is osteoarthritis?
DJD, degenerative joint disease. progressive deterioration and loss of cartilage and bone
What is rheumatoid arthritis?
Inflamatory disease- chronic- inflamatory changes in joints (primarily synovial).
synovitis
Etiology or 5 factors effecting osteoarthritis
age genetics obesity trauma occupation- post menopausal; lack of exersize
Etiology or 6 factors effecting rheumatoid arthritis
1.autoimmune 2genetic 3female rep.hormones 4virus 5 stress; 6 chemicals: nicotine and caffiene
what is diagnostic test for osteoarth.?
x-ray
what is diagnostic test for rheumatoid arthritis? (6)
x-ray, RF, ANA, ESR, cbc Arthrocentesis.
What is RF test for?
rheumatoid factor- measures presence of unusual antibodies
what is ANA?
antinuclear antibody test- measure titer of unusual antibodies that destroy nuclei of cells
what is ESR?
confirms inflammation test for rheuma. arthritis
what can cbc confirm?
anemia
what is test that samples synovial fluid and relieves pressure?
arthrocentesis
what are clinical manifestations of oseoarthritis? (3)
pain- worse w/use better w/rest; stiffness joints; joint changes-enlargement due to bony hypertrophy
what joint changes are associated with osteoarthritis?
heberdens nodes, crepetis, unilateral pain, no inflamation.
what are the early manifestations of rheumatoid arthritis?
fatigue weakness stiffness anorexia persistant low fever
joint inflam- pip and mcp
bilateral, symmetrical progresses in # of joints
late manifestations of rheumatoid arthritis?
joint deformity
swan neck or ulnar deviation
bouchard nodes
what are bouchard nodes vs herberden nodes?
both reactive bony overgrowth with oseo and rheumatoid arth. bouchard proximal herberden distal
pain in spine related to pressure from rheumatoid arthritis?
rabiculapathies- compression of spine press on nerves
late manifestations of rheumatoid arth?
osteoporosis, subcutaneous nodules, periperal neuropathy,pericarditis, vasculitis, sjogrens disease, renal disease pulmonary complications
what is sjorgrens syndrome?
glands stop secreteing- dry syndrome
What is first line drug for osteo arth
tylenol and nonsalicylates- aspirin, buff. aspirin w/ meals
what is NSAID? examples.
non steroidal anti inflamm. drug.; aleve motrin naprosin
prob with nsaids
cause sodium retention
better pain control intervention if hyper tension or kidney disorder; nervous system issues disorient and head aches; gi bleeding
name 2 synthetic joint fluid implants for oseo arth
hyaluronic and synvisc
name 2 muscle relaxants for osteo arth
flexeril and robaxin
topical prep for osteo arth
capsaicin
what is last resort drug relief for oseot arth?
steroid injections
non pharmalogical relief for osteo arth?
rest; thermal modality- moist heat if not diabetic, cold only for inflam.; positioning
what does TENS tx do?
diverts attention from pain
diet should be?
night veges; tomatoes, eggplant
surgery contraindications?
infection, inflammation or osteoporosis; recoup is 8 weeks
Hip replacement post operative procedures?
prevent dislocation- subluxation- keep legs abducted prevent flexion 90 degrees. turn as ordered
assessment for dislocation?
increased pain; shortening of extremity rotation of extremity (**in is out)
prevent deep vein thrombosis and pulmonary embolis
a) venodyne boots b) leg exersize c)red,swell, pain
d)neurovascular assess e)anticoagulents
what anticoagulants might be given after surg?
hep. injection- sub cut
lovenox- coumadin bld tests
aspirin- 6-12 mo
what is activity progression?
1 day bed rest; 2nd day movement and walking
what will prevent atrophy of muscle
continuous passive movement and knee imobilizer to extend at bed time
7 classifications of drugs used for rheumatoid artheritis
1.salicylates 2 nsaid 3. cytotoxic 4. gold salts 5. minocycline 6 corticosteroids 7 remicade.
name cytotoxic drug and describe and why used
methotrexate: 1x week
casues pcp; mouth sore;dyspnea; liver inflam;bone marrow suppression
name 2 gold salts
myochrisine- injectable
ridaura
which rheumatoid arthritis drug do you have to monitor cbc and urine?
gold salts
what are side effects of gold salts?
takes 3-6 mos to work; protienurea, mouth ulcer, skin rash anemia and pain; diarrhea nv
what is minocycline?
rheum arht; immune modifier: anitmicrobial and anti inflammatory lower side effects: not as effective
corticosteroid side effects
DM, infection, fluid and electrolyte imbalance, glaucoma
what is nursing intervention for cytotoxic drug side effect
magic mouth wash- mylanta and benedryl: avoid citris, spice and caffeine: no vaseline on wound
what is gout?
systemic disease; urate crystals deposit in joints and other body tissues; infamation
describe 2 types of gout:
primary- production of uric acid exceeds excretion- genetics-middle age or older
Secondary-excessive uric acid due to renal insufficiency, diuretics, chemo- all ages
what are 4 phases of gout?
asymptomatic hyperuricemia- serum level increases
acute- painful inflamation in small joints
intercritical- remission
chronic- after repeated episodes, can feelcrystals under skin and in organs
what are manifestations of gout?
acute- painful joints
chronic- tophi- papules- destroy cartilage
renal stones
why was it called rich mans disease?
wealthy kings ate foods like shell fish, game meats organ meats etc..
How is it diagnosed?
ESR, serum uric acid up, urine uric acid up, kidney tests, arthrocentesis
Signs and symptoms of gout
hot and red
medications for acute gout:
colchine- decreases deposit.5 mg evert hour until pain alleviated
NSAID- indomethacine; pain and inflammation
medications for chronic gout:
allopurinal(zyloprim)- inhibits enzyme 3xweek
probenecid- increases secretion of uric acid 250 bid-500bid
colbenemid- mix of 2 above
what should be avoided if gout present?
aspirin and diuretics, alcohol, no fasting, low purine stress
what should be encouraged if gout is present?
water intake, fruit juices, alkaline ash diet, citris