Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
30 Cards in this Set
- Front
- Back
|
Define RA (RHEUMATOID ARTHRITIS)
|
Chronic systemic auto-immune disorder; long lasting which involves multiple body systems
|
|
|
RA Etiology
|
Unknown
2-3 X more frequent in women than in men Onset usually 30-40 yr olds can be hereditary |
|
|
RA Pathology
|
Systemic
May be abrupt w/simultaneous inflammation Characterized by remissions and exacerbations |
|
|
RA Signs and Symptoms
|
-inflammation of joints
-pain -morning stiffness -limited movement -deformity -sudden onset |
|
|
RA Eval
|
-ADL
-Strength -Endurance -ROM -Pain -Dexterity |
|
|
RA Interventions
|
-Joint protection
-Joint immobilization (splinting) -Activity modification -Maintain or incr strength and function -Energy conservation |
|
|
Give examples of assistive devices used in DECREASED ROM
|
-Reachers
-Long handled shoe horns -Extended mop handle -Revolving space savers -Peg boards |
|
|
Give examples of assistive devices used in IMPAIRED GRASP
|
-Built up soft handles
-Lg pens -Universal cuffs |
|
|
Give examples of assistive devices used in INSTABILITY
|
-Nonskid mats, grab bars, suction brushes
|
|
|
Give examples of assistive devices used in POTENTIAL FOR JNT DEFORMITIES
|
These AD are to help prevent static or prolonged holding and to increase leverage:
-extended faucet handles -adapted key holder -vegetable peeler at MPs -book stand, bowl holder |
|
|
Give examples of assistive devices used in DECREASED STRENGTH
|
Example of AD to modify work heights, raise height of beds & chairs to make standing easier:
- Raised toilet seats |
|
|
Treatment Methods for RA
|
-REST: to reduce inflammation and not aggrevate pain. Localized rest may include wearing a splint; psychological rest by focusing on enjoyable things vs work.
-POSITIONING: Maintain good alignments while sitting, standing, even sleeping. Don't use big pillows, pillows under knees -PAMs: Heat, TENS, COLD (if tolerated). -THERAPEUTIC ACTIVITY AND EX: Used to promote joint func, MS strength, endurance -SPLINTING:To reduce inflamm, support joint for func -ADL TRAINING: Modified methods and use of adaptive equip |
|
|
Name the 4 stages of RA and some symptoms
|
1. Acute: Red/Hot joints, pain w/any movement, stiffness
2. Subacute: Pink/Warm joints, pain but unlike that of the acute stage 3. Chronic-Active: Inflammation may be gone, pain tenderness reduced, can tolerate movement, low endurance. 4. Chronic-Inactive: No inflammation, pain due to stiffness from disuse; decrease func from disuse;limited ROM, MS atrophy, or contractures |
|
|
What exercises are recommended the ACUTE stage
|
Active-assistive with gravity eliminated and perform with tolerance of pain; choose an appropriate time for pt in reg to pain
-Gentle passive & active ROM to point of pain, but DON'T stretch 2 X a day do 1-2 reps of complete ROM to maintain -Isometric ex w/out resistence to maint strength 1-3 reps per MS group/day |
|
|
What exercises are recommended the SUBACUTE stage
|
Active & Passive ROM w/stretch (not to end point)can be started; Resistive isotonic and graded isometric w/minimal stress to joints
|
|
|
What exercises are recommended the CHRONIC-ACTIVE and CHRONIC-INACTIVE
|
Stretch at the end of the range may be included during ROM; RESISTIVE ISOTONIC AND ISOMETRIC ex w/out overstressing joints
|
|
|
Why do we splint RA joints:
|
-rest
-prevent further deformities -In some cases restore deformities -support/stabilize |
|
|
Body joints usually affected in RA?
|
Synovial Joints
Most affected body parts are: the hands: CMC joint PIP joint MCP joint Wrist Ankles Knees Hips |
|
|
What is Ulnar Drift
|
Ulnar drift: radial deviation- the hand moves toward thumb and tendons pull fingers toward little finger.
Using fingers toward radial deviation help prevent further ulnar drift |
|
|
What is swan-neck deformity
|
Inflammation of the MCP joint causes intrinsic MS to become tight. The MS pull on the finger causing the DIP joint to flex and the PIP joint to hyperextend
|
|
|
What is boutonniere deformity
|
The inflammation of the PIP joint. The damaged ligaments stop the joint from straigthening. The pull created causes the DIP joint to extend (go backward).
|
|
|
Thumb deformities
|
inflammation of the DIP joint and/or MCP joint of the thumb
|
|
|
Joint Protection: Give the 6 examples
|
1. Respect pain
2. Maintain MS strength and ROM 3. Avoid positions that put stress on involved joints 4. Avoid staying in one position for a long time 5. use the strongest joints and MS avail. 6.Distribute the work load over several joints. |
|
|
How can Joint Protection be accomplished in principle "Respect Pain"
|
-Don't tough it out. Pain will lead to more pain!
-If pain last more than 1 hr after the activity, chg, break it down into steps, use less effort -Or avoid the activity that is straining an already strained joint |
|
|
How can Joint Protection be accomplished in principle "Maintain muscle strength & ROM"
|
-Try to use FULL ROM & strength daily by:
using long, flowing strokes when sweeping, mopping, vacuuming; straightening and bending the arms when ironing, reaching for objects |
|
|
How can Joint Protection be accomplished in principle "Avoid positions that put stress on involved joints"
|
-normal way of doing things may need to be changed. Examples:hold knife like dagger, use pizza cutter instead; push up from chairs w/palms not fingers; dusting mitt encourages extended fingers; learn to open jars by radial deviation
|
|
|
How can Joint Protection be accomplished in principle "Avoid staying in one position for a long time"
|
eliminate staying in one postion: don't hold things for long time use bood stand; don't hold bowl while stirring, instead set in a partially opened drawer
|
|
|
How can Joint Protection be accomplished in principle "Use the strongest joints and MS available
|
use of larger joints reduce the stress on smaller ones. Ex. carry purse on shoulder instead of hand; push open door w/side of arm instead of hand; add cloth loops to drawers to pull w/forearm
|
|
|
How can Joint Protection be accomplished in principle "Distribute the work load over several joints"
|
Use palms of both hands to lift and hold cups, plates, pots; carry heavy loads close to body w/arms; slide object along counter; may reduce stress by wearing a wrist splint
|
|
|
Treatment Precautions for arthritic patients
|
-avoid fatigue
-respect pain -avoid static, stressful, resistive activities -Limit the applicatoin of heat to 20 min -Use resisive ex w/caution and never with unstable joints -be aware of sensory impairments |
