Signs and Symptoms of ACute Gouty Arthritis including the Treatment

- it is SYSTEMIC - it is due to increased uric acid serum level (causes gout) or deposition of urate crystals in joints and other body tissues - Due to a disorder of purine metabolism, excess uric acid in blood (Uric acid is the end product of purine diet). - Gouty Arthritis is also caused by hyperuricemia (increase uric acid in the blood). Nursing Goal of Gouty Arthritis to relieve pain to protect affected part

Overview and Osteoarthritis Symptoms

Osteoarthritis Due to wear and tear of the cartilage caused by overused joints Mostly affected are the weight-bearing joints (knees, hip, and lower spine). This joints are inflamed Formation of bony buildup and loss of articular cartilage causing crepitus degenerative joint disease (hips and knees). Causes of Osteoarthritis

Idiopathic excessive use of a specific joints repeated joint injury old age and obesity

Osteoarthritis Symptoms and Signs limited ROM pain in motion compression of the spine as manifested by pain pain increases with activity joint stiffness and immobility muscle spasms skeletal muscle atrophy Heberdens Nodes - bony nodules on distal finger joints Bouchard's Node

Diagnosis of Osteoarthritis - X-ray Treatment of Osteoarthritis Analgesics rest (best management) hot moist pack Paraffin wax (brushing technique)

Nursing Goals of Osteoarthritis to relieve pain to prevent further stress of joints (plan ADL or activity of daily living) to maintain regular exercise

AIDS Research (Acquired Immune Deficiency Syndrome)

AIDS research (Acquired Immune Deficiency Syndrome) Overview Caused by human immunodeficiency virus When the T4/CD4 cell count falls below 200/mL opportunistic infections are greatest because the immune system is severely depressed Incubation Period estimates range from to 10 years and may be longer The antibodies produced by the body are generally first be detected in the blood in 2 weeks to 3 months or longer after infection AIDS Clinical Findings 1. Subjective:

 Anorexia, fatigue, dyspnea, chills, sore throat 2. Objective: Positive for HIV antibody: ELISA and Western Blot Positive for HIV itself: Polymerase chain reaction Decreased CD4/T4 cells Night sweats Enlarged lymph nodes Wasting syndrome: wt loss exceeding 10% baseline weight, chronic diarrhea for more than 30 days, chronic weakness and constant fever HIV encephalopathy: memory loss, lack of coordination, partial paralysis, mental deterioration HIV is present in Blood Semen Vaginal secretions Blood-tinged saliva Tears Breast milk CSF The virus is not viable outside the body

AIDS: Classification System T4/CD4 categories 1. Category 1: less than or equal to 500 cells /mL 2. Category 2: 200 to 499 cells/ mL 3. Category 3: less than 200 cells/ mL Clinical Categories 1. Category A: asymptomatic HIV 2. Category B: presence of opportunistic infection/s 3. Category C: presence of all opportunistic conditions AIDS OPPORTUNISTIC INFECTIONS 1. Protozoal: PCP, toxoplasmosis 2. Fungal: Candidiasis, histoplasmosis

3. Bacterial: Mycobacterium avium-intracellulare complex Mycobacterium tuberculosis 4. Viral: Herpes, varicella-zoster, cytomegalovirus 5. Malignancies: Kaposis sarcoma, B-cell lymphomas, non-Hodgkins lymphoma AIDS: Therapeutic Interventions No For For For cure, prevention is the key PCP: trimethorprim sulfamethoxazole (Bactrim), pentamide TB: isoniazid, rifampin, ethambutol Fungal infections: nystatin, amphotericin B, ketoconazole