Prepared by: Caroline V.

San Diego MAN,RN 1

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ARTHRITIS
Inflammation
Pain
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OSTEOarthritis
Degenerative joint disease
involve joint cartilage
osteophytes/spurs

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OA
A dvanced age, Degenerative Joint disease
P revious jt damage
O besity
W ear and tear- of JOINT CARTILAGE
W t. bearing joints- KNEE, Lumbar, CERVICAL 6
S/S
• Pain, assymetrical, non systemic, localized
• Stiffness of joints <30mins in A.M
• Heberden’s and Bouchard’s nodes

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 Management
Wt reduction
Topical analgesics
Intra-articular steroids
PARACETAMOL, NSAIDS

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 NSAID

• COX 2 INHIBITORS
Celecoxib (Celebrex)
Etoricoxib (Arcoxia)

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ra

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Rheumatoid arthritis

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• Systemic - women

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Which client is most at risk for
developing RA?

• A. 25 yo woman
• B. 40 year old man
• C. 65 year old woman
• D. 70 year old man
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R
A- POLYARTICULAR
Nodule
Factor, ESR, (+) ANA
aynaud’s phenomenon
Autoimmune, chronic- (remis, exacer)
Gender specific- girls
Systemic, Symmetrical, bilateral
Stiffness >30 mins 15
oa

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 MGT

• NSAIDS reduce inflam

• M ethotrexate
A ntimalarials
G old therapy
S teroid
Nutritional therapy
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 NSAIDS

•COX-2 INHIBITORS
•Celecoxib- celebrex
•Etoricoxib- Arcoxia

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 Nrsg. MGT
Splints to immobilize affected extremity
COLD packs - acute phase of pain
HEAT application - inflammation subsides
Client education- remission. Exacerbation
Nutrition treatment
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 Gout

• CAUSE:
Purine metabolism d/o
Leads to Uric Acid
st
Involve 1 MTP joint-
MONOARTICULAR 20
Meta tarso phalangeal joint

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• Great toe
• TOPHI-UA CRYSTALS- JOINTS, EARS, KIDNEY

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 1. Colchicine

Decrease inflammation
Used aCute attack

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 2. Allopurinol

Blocks formation of Uric Acid

Inhibits xanthine oxidase

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• PURINE--  URIC ACID
XANTHINE OXIDASE

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3. Probenecid
enhance excretion of UA

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 DIET-food to avoid
• Foods high in PURINE

Alcohol, Anchovies
Shellfish
Organ meats
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Osteoporosis
OSTEOCLASTIC / RESORPTION

BMD

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ASSESSMENT
• Low stature
• Fracture

• Bone pain

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• DEXA-scan
Detects bone mass density
• X-ray studies- fracture

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 Medical Mgt: Osteoporosis

• Diet therapy
•Drugs

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Calcium supplement

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 Bisphosphonates
Ibandronate
SE: esophageal ulcers
Take- empty stomach in am, full glass H20
Sit upright 30 mins after intake

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 Calcitonin

Sq
I M
N asal spray
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 OSTEOPOROSIS : NI

• Prevent injury
• Isometric exercise to strengthen
trunk muscles
• AVOID bending, strenuous lifting

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