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Case study

Sociodemographic data:

Special unit: dar om kolthom
Patient's name:fathia abd el aziz
Sex: female
Date of admission: 2 years ago
Stay period :admitted since 2 years until death
Age: 71 years old
Level of education: diploma
Marital status: widow
Years of retirement; no occupation
Religious: muslem
Occupation before retirement; house wife
Anthropometric measurement
Weight; about 60 kg
Height; about 160 cm
BMI; weight\height 60\1,6
She is an ideal weight
Vital signs
Respiration; 19 c\m
Pulse; 88 b\m
Temperature; 36,5 c
Blood pressure; 110 \70 mmhg
Present history:
Diagnosis / Present illness: knee osteoarthritis -
Predisposing factors: diabetes mellitus -

Radiological evidence of osteoarthritis can be found in over 90% of the population.insomnia Introduction Osteoarthritis is a chronic disease of the muscle skeletal system. .and knee joint pain 7. Neurological assessment: inflammation of nerves 4. Head / hair: white color 9. muscle stiffness. Respiratory system: no abnormalities 2. Musclo skeletal system: limited range of motion. It mainly a non inflammatory disease of synovial joints and the most important cause of disability in old age. Knee osteoarthritis is the most common type. Past history: Medical: Diagnosis / Duration: diabetes mellitus - Surgical -No surgery performed Allergy history:No Family history:No :Patient's Physical Assessment 1. Eyes: inflammation. dry mucus membranes 5. Skin assessment: shrinks.partial loss of teeth 13. Activity and rest: limited mobility . Circulatory system: high blood sugar 3. pain with movement . dry. without systemic involvement. creases 8. cataract 10. Incidence and prevalence Osteoarthritis is the most common joint disease found in 70 % of the population over 60 years of age in world wide. difficulty in movement. Mouth: dry mucus membranes . affect on all ages especially age over 40 years. Nose: normal 12. Ears: normal 11. Urinary system: polyuria 6. Neck: normal 14. Gastrointestinal system: constipation .

etiology is known Stages of OA Stage I. etiology is known which result from.Definition of disease: a degenerative disease of diarthrodial (synovial) joints characterized by breakdown of articular cartilage and proliferative changes of surrounding bones. Trauma Previous joint disorder Congenital hip dislocation Infection. overtime the cartilage may wear away entirely. diabetes mellitus Hematologic. hemophilia . In healthy joints . Cartilage is the tough elastic material that covers and protects the ends of bones. Pathophysiology of disease: It is caused by breakdown of cartilage. doubtful (normal) Stage II. etiology is un knee OA as a result of diabetes mellitus known Secondary OA. and the bone underneath thickens. and the bones will rub together. the cartilage gradually becomes rough and thin. Joint osteoarthritis. severe Etiology: According to patient (actual) According to literature(ideal) The client complain from secondary Primary OA . The slippery surface of the cartilage allow the bones to move smoothly.cartilage acts as a shock absorber when you put weight on the joint. Bits of cartilage may break off and causes pain and swelling in the joint between bones .this pain is called inflammation. septic arthritis Metabolic disease(gout) Endocrine disease . Classification Primary OA. etiology is nu known Secondary OA. mild Stage III. moderate Stage IV.

elderly are more common Sex. RA Risk factors Age.knee. males more than females Obesity.feet and spine -non weight-bearing joint such as finger joints signs and symptoms According to patient(actual) According to literature(ideal) The client complain from the following Pain especially when moving a signs. Inflammatory. due to stress on the weight-bearing joints Genetics Trauma(daily) Most affected joints According to patient(actual) According to literature(ideal) The client has a type of weight-bearing -weight-bearing joints such as joint which is knee joint 0A hip. joint Leg pain Swelling or bumps Knee Joint pain Sore and stiffness Difficulty in movement Joint pain Limitation of range of motion Deformity Stiffness Limitation of range of motion Swelling Hard movement(walk and up stairs) Hear grating sound when the roughened cartilage on the surface of the bones rubs together Diagnosis .

Palpation. stiffness . deep tendon reflex performed . when deep tendon reflex Percussion. observe for signs and Physical examination symptoms appeared Inspection. limitation of range of motion. narrowing of joint space due to loss of cartilage CT scan MRI Bone cysts arthroscopy Complications: According to patient(actual) According to literature(ideal) No any complications appeared 1-The muscles that hold the joint in place weaken because they are not being used 2-overtime. the joint losses its shape and does not work at all . palpate affected joints difficulty in movement for any swelling pain and Palpation . diabetes mellitus 10 Physical examination years ago Inspection. History of signs and symptoms History And its duration History of signs and symptoms and I Family history found knee joint pain.According to patient(actual) According to literature(ideal) When I performed discussion with client. difficulty in Medical history movement. the client had limited range Diagnostic investigations of motion Lab tests Diagnostic investigations Blood test Lab investigation Endocrine function test Blood test biopsy from synovial fluid Blood sugar CSF culture Radiological investigations Radiological investigations x-ray x-ray. pain in knee joint . Surgical history and stiffness Lifestyle history Medical history. tenderness of knee joint tenderness Percussion . History I have been found.

B12).B6.inflammatory -diamicron.2 tablets daily morning and1 drugs (NSAIDS) such as aspirin in evening Surgical -arthroscopy -osteotomy -arthroplasty(joint replacement) Role of nurse through three levels of prevention:- 1-primary prevention(prevent onset of disease) A-Health promotion -diet Increase calcium intake Increase vitamins intake such as ( vitamin B1.ophthalamic solution) 2 temporary pain drops per day -non steroidal anti. drugs. acetaminophen to relieve mild to -Neurovit (vitamin B1.. Management : According to patient(actual) According to literature(ideal) Medical Medical -the client had been taken the following -Take analgesic drugs. tablets moderate arthritis pain for diabetes -creams and gels to remove -Tymer(sterile.B6 – B12) Increase dietary food such as(eggs – milk –milk products) Decrease fat intake Low salt diet Decrease sugar intake -Exercise Regular exercise Avoid straining on bone and joints Avoid excessive range of motion -Sleep and rest Sleep 6-8 hours every day One or two naps every day Change position B-Health Education .

causes and sings &symptoms of disease Healthy life style Expose to sunlight frequently Advice client to eat high fiber diet such as ( fruit & vegetables ) Teach client to perform regular exercises without straining on bones and joint Teach about importance of personal hygiene specially foot hygiene C-Specific protection Take analgesic Take local creams and gels 2-Secondary prevention A-early diagnosis: as before B-early treatment -Modification life style habits : as before 3-Tertiary prevention A-avoid complication Complete course of treatment Regular follow up Tell the doctor if appear any signs of complication Avoid lifting heavy objects Avoid straining on bones & joint B-Rehabilitation -Physical Learn client types of medication routs &side effects -Social Learn how to prevent recurrence of disease -Psychological Teach client how to deal with her disease and give support Outline .-Help client to identify the following Definition.

-socio-demographic data -physical assessment -introduction -incidence & prevalence -definition -pathophysiology -classification -stages -causes -risk factors -sings & symptoms -most effected joint -diagnosis -complication -treatment -role of nurse -nursing care plan -reference Outline .

-introduction -incidence & prevalence -definition -pathophysiology -causes -risk factors -sings & symptoms -most effected joint -diagnosis -complication -treatment -role of nurse -nursing care plan -reference .