Musculoskeletal System Inflammatory And Connective Tissue Disorders 63

Front 1

many clients with musculoskeletal disorders can be treated (out, in)

Back 1

outpatient

Front 2

subtle changes in geriatric client that must not be overlooked which would delay treatment

Back 2

generalized pain

cognitive changes

depression

fatique

Front 3

arthritis

Back 3

general condition characterized by inflammation and degeneration of a joint

Front 4

• Many different inflammatory disorders
  
• disorders in this group are the most common
  

orthopedic problem

• involve inflammation and degeneration of
  

connective tissue structures , especially joints

Back 4

Rheumatoid disorders

Front 5

RA is a systemic inflammatory disorder of tissue /joints characterized by 3

Back 5

-chronic

-remissions

-exacerbations

Front 6

potential for disability with RA is great because 2

Back 6

effects on joints

effects on other systems

Front 7

theories of cause RA 3

Back 7

-cause unknown

-believed to be autoimmune disease

-genetic predisposition

Front 8

characteristics of RA 5

Back 8

-affects women more than men

-20-40 years of age onset usually

-incidences equal with gender as people get older

-crippling disease, affects daily life

-periods of exacerbations and remissions

Front 9

general SOS of RA

Back 9

-joint pain (come and go )

-swelling (come and go)

-warmth

-erythema (redness)

-fever maybe

-fatigue

-malaise

-anorexia

-low tolerance for stress

-sensitive to temperature changes

Front 10

why does a client with RA develop Anemia

Back 10

effects of RA on the blood-forming organs

Front 11

Sjogren's syndrome

Back 11

dry eyes and mucous membranes

Front 12

other systemic changes with RA

Back 12

-vasculitis (inflammation of blood vessels)

-neuropathy (numb, pain from nerve damage)

-scleritis (inflammation of sclera)

-pericarditis (inflammation of pericardium)

-splenomegaly (enlarged spleen)

-Sjogren's syndrome (dry eyes mucous membrane)

Front 13

specific SOS of RA (late SOS ) 5

Back 13

-subcutanous nodules, stiff and movable over bony prominences

-muscles weaken and atrophy

-smooth , glossy , cold clammy extremities

-flexion contractures

-proximal finger joints swell and deform

Front 14

swan neck deformity

Back 14

hyperextension of the proximal PIP joint with fixed flexion of the distal DIP joint

Front 15

Boutonniere deformity

Back 15

persistent flexion of the PIP joint with hyperextension of the DIP joint

Front 16

Ulnar deviation

Back 16

fingers deviating laterally toward the ulna

Front 17

subcutaneous nodules from RA

Back 17

firm, freely moveable , rubbery or granular nodules caused by deposit

Front 18

synovial cysts from RA

Back 18

baker's cysts in popliteal fossa. filled with synovial fluid that may be found in a periarticular areas in elbow, shoulder, or small joints

Front 19

arthritis from RA

Back 19

bilateral involvement of the small joints and later the large joints. swollen, red , inflammation, flexion contractures are common

Front 20

systemic rhematoid vasculitis From RA

Back 20

immune complex-mediated inflammation in arteries. life threatening if in critical areas. causes lesions. necrosis.

Front 21

compression neuropathy from RA

Back 21

mainly causes peripheral nerve entrapment with carpal tunnel syndrome. paresthesias, pain, burning, muscle wasting, weakness common symptoms

Front 22

cardiac disease from RA

Back 22

pericardial lesions and effusions common

and may or may not be symptomatic. conduction blockages due to rheumatic nodules may cause heart block

Front 23

pleuropulmonary disease from RA

Back 23

pleural effusions or pleuritic pain common.

pulmonary fibrosis or or lung disease common

Front 24

episcleritis RA

Back 24

inflammatory condition of the connective tissue

between the sclera and conjuctiva

Front 25

sclera with RA

Back 25

inflammatory condition of the sclera that can cause sceral perforation

Front 26

sicca syndrome with RA

Back 26

condition of dry eyes and dry mouth that can result from infilteration of the lacrimal and salivary glands with lymphocytes

Front 27

ulnar deviation, boutonniere deformity , swan neck deformity with RA are usually found in

Back 27

the PIP joints mostly

Front 28

chronic pain with RA is usually worse at this time of day

Back 28

morning after a night's rest

Front 29

in RA joints lose motion over time because

Back 29

each exacerbation causes more inflammation which leads to more joint damage, pannus (desctructive granular tissue) fills joint margins leading to anklylosis (joint immobility ) . contraction and joint immobility are common

Front 30

in arthrocentesis the synovial fluid for RA

Back 30

cloudy

milky

dark yellow

contains leukocytes and complement proteins

Front 31

X ray for RA show 3

Back 31

-joint changes

-narrowed joint spaces

-bony erosions

Front 32

with RA C4 complement protein level

Back 32

decreased

Front 33

ESR with RA level

Back 33

elevated

Front 34

two tests that strongly suppport RA diagnoses

Back 34

positive CRP test

positive RF findings

Front 35

treatment for RA 5 things for RA

Back 35

-no cure

-decrease joint damage by decreasing inflammation before ankylosis occurs

-relieve discomfort

-restoring function of affected structures

-preventing or correcting deformities

Front 36

to reduce episodes for RA the nurse would suggest 4

Back 36

-optimal health conditions to reduce inflammation

-total body rest and joint rest

-balance rest with exercise

-do not need to modify diet unless other disease present, it will not help

Front 37

nutrition with RA

Back 37

-no nutrition can prevent RA or cure it

-eat Omega 3 fatty acid found in fish , mackeral,

herring, salmon , flax seed oils, canolla inhibit prostaglandins for inflammation, no fish oil supplements

-monitor for weight changes, malnutrition common

-discourage quack cures

Front 38

when client have joint and bone disease and start to feel better nurse teaching for drugs should include

Back 38

do not stop taking the medication without first consulting with your doctor

Front 39

arthroplasty

Back 39

tx for RA for joint deformity

-reconstruction of the joint using an artificial joint . restores lost function and relieves pain.

Front 40

synovectomy

Back 40

a tx for or relief of joint pain. remove the lining of the joint , surgery

Front 41

TENS unit

Back 41

transutaneous electrical nerve stimulation to relieve pain in a particular joint. portable machine that has electrodes that the client attaches to skin , can be used for RA

Front 42

nurse management for RA 6

Back 42

-maintain optimal health

-relieving pain techniques

-reducing stress

-decreasing the inflammatory process

-medication regimen

-hot and cold technique to relieve pain, tens

Front 43

nurse care in home setting RA

Back 43

-teaches to use extra time for ADL

-providing nurse assistance for ADL

-make sure home environment safe

-collaborates with PT for exercise regimen and aids , using aids, aquiring them

-teaches about energy consumption to promote restful periods

-educate client about disease so they don't spend a fortune on quack cures

-help client cope with physical changes and limited mobility

Front 44

when joints are severely inflamed the RA clietn should

Back 44

use a splint to reduce but not totally eliminate active motion

Front 45

clients with RA should avoid this position

Back 45

flexion

Front 46

to prevent ankylosis , muscle wasting, osteoporosis and debilitating effects of long periods of rest the nurse tells client with RA

Back 46

to move affected parts gently

Front 47

The most common form of arthritis , wear and tear

Back 47

Degenerative joint disease aka osteoarthritis