OSTEOARTHRITIS

 The most common DEGENERATIVE NON-INFLAMMATORY

joint disease. NON-PHARMACOLOGIC
 The CARTILAGE is the one affected
 LOSS ARTICULAR DAMAGE – acts as a cushion between 2 1. Heat and Cold ( Heat for 15 – 20 mintes for it relaxes the
bones. muscle surrounding the joint thus you are decreasing the
 No longer considered a normal part of aging pain) (Cold numbs the pain and reduce the joint swelling, for
 Growing older is a risk factor it blocks the nerve impulses to the joint)
 20 – 30 is the age affected. 2. Resting the joint
 Occurs as idiopathic (Genetic, Aging, Obesity and Smoking) 3. Avoiding the joint
or Primary or Secondary – too much (Trauma, Stress or 4. Diet (Acquire them to eat rich in grains, fruits, vegetables
inflammation) and omega 3, for it reduces inflammation

PATHOPHYSIOLOGY NURSING CARE

Aging or Trauma | loss of proteoglycans 1. Lose weight because you are increasing stress on the
damage joint
synovial fluid provides lubrication and nutrition to decreases 2. Wear low-heeled shoes
osteoarthritis 3. Keep warm
4. Carry object with open palm – clenching puts strain
Diminish food and fluid
5. Don’t sit / stand for more than 1 hour
The cartilage and bone will disappear 6. Don’t carry heavy objects
7. Avoid walking up and down in a stair
Development of bone spurs/calcification and ulceration. 8. Tried not to lie on the affected hip
o Always put a pillow between the legs.
SIGNS AND SYMPTOMS
9. SIDE SLEEPERS
 Systemic manifestation are not present o Put a firm pillow between the knees to prevent
o Usually affects joints asymmetrically pulling spile out of the alignment
 Stiffness often occurs after awakening and last up to 30 – 40 o It takes pressure of the hips and joints
minutes 10. Do at least some weight-bearing to strengthen the bone
 TENDER when palpated o Ease pain and improve by squeezing fluid in the
 CREPITUS and GRINDING OF THE JOINT join
 Stimulates regeneration of the cartilage,
JOINTS COMMONLY AFFECTED which increase blood supply by driving
the synovial fluid through the joints
 Weight bearing joints
cartilage.
o Cervical, lumbar spine
11. Avoid high impact activities (running,jumping, twisting)
o Hips
12. Stretch regularly to keep muscles loose.
o Knees
13. Acupuncture
 As the cartilage stiffs and loses its elasticity
14. Glucosamine and chondroitin
 Painful bone – bone contact o Supplements that prevents cartilage from
 Spurs grow and body cyst develops breaking down
 Bony nodules in the distal part is called HERBERACTUS o NSAIDS - Ibufrofen
NODES  Shots of Anti-inflammatory drugs
 Bony nodules in the proximal is called BOUCHARDS NODES  Betamethasone
DRUG THERAPY  Methylprednisone
 Triamcinolone
 NSAIDS 15. Hyaluronic Acid: Joint Lubricant
o Aspirin o Collagen is decrease by the age of 30Years old and
o Diclofenal the drug replaces the natural hyaluronic acid that
o Ibuprofen has been depleted due to inflammation and aging
o Naproxen o You exercise to push synovial fluids to joints acts
 COX – 2 Inhibitors as a lubricant.
o Meloxicam – Mobic o Expensive
o Celecoxib – Celebrex
o Etericoxib – Arcoxia
  Taking this will destroy the bone
marrow for a long time.
RHEUMATOID ARTHRITIS OSTEOARTHRITIS  S/E: Nausea, Vomiting and
Young age to middle >40 and above Diarrhea
Female Male and Female  A/E: Bone marrow
Lost weight Overweight
suppression and GIT Bleeding.
Systemic Localized
o Allopurinol – Zyloprim
Small Joints and Symmetric Weight – Bearing joints are the
 Never given for acute attack, only for
affected one
chronic
More than an hour of stiffness Less than an hour of stiffness
 A xanthine oxidase inhibitor that blocks
All-over Herberdens and bouchard
nodes. the formation of the uric acid.
 Mild S/E: GI Upset, Headache and
Metallic tase.
GOUTY ARTHRITIS PATIENT EDUCATION
 Joint Disorder characterized by acute inflammation affecting  During acute phase: PAIN MANAGEMENT
the BIG TOE (Because uric acid loves the cold area) o Bed rest for the duration of the attack and for 24
 More common in males hours after symptoms
 30 – 50 years old is the age affected. o Take pain relievers
PATHOPHYSIOLOGY o ICE – because it causes vasoconstriction thus you
are decreasing the blood going to the injury,
Uric acid formed when body breaks down molecules caused PURINE decrease swelling and decrease pain,
 building block for DNA o Bed cradle a device to ---
 The 1st line of defense is weight reduction
During breakdown the enzyme xanthine oxidase is the catalyst for the o Eat less
conversion of hypoxanthine which is the Uric acid  Avoid aspirin or diuretics because it will limit the excretion
2 CAUSES of uric acid
 Increase fluid intake to drive the uric acid away through
 Primary Gout urination
o Inherited  Avoid eating high purine foods, including red meats,
o Overproduction of Uric acid seafoods and alcohol.
 Secondary Gout
o Due to hypertension NURSING INTERVENTION: RICE
o DKA  R – REST
o Hemolytic Anemia o Prevents additional injury
o Aspirin (Inhibits the kidneys to excrete the uric o Promotes healing
acid) o And movements should be limited
COMPLICATIONS OF GOUT  I- CE
o Applied intermittently for 20 -30mins during the
 Kidney stones first 24- 48 hours
o Uric acid crystallizes and turns into stones. o Provides vasoconstriction thus decreasing the
bleeding and edema
DIAGNOSTICS o Warm up time of 10 – 15mins between
applications.
 Uric Acid Level
o C- COMPRESSION
o Male: 4- 8.5mg/dl
 An electric compression bandage
o Female: 2.7 – 7.5mg/dl
 Controls bleeding
 Fluid Synovial Analysis
o Fluid is translucent  Reduces edema
o With yellow uric acid  Provides support to the
 BUN and Creatinine injured tissue
o E- ELEVATION
TREATMENTS  To mobilize excess fluid from the area
and impede further edema
 For Pain  After acute inflammation stage: 24 -48
o Colchicine hours after injury heat may be applied
 Inhibits the migration of the WBC to the 4x a day for 5- 30 mins.
injured site
 Maximum dose is 6mg during an acute
attack over 4 days