Presentation Transcript
Chapter 54Assessment and Management of Patients With Arthritis :Chapter 54Assessment and Management of Patients With Arthritis
Arthritis :Arthritis Refers to the inflammation of a joint, while rheumatic disease involves the bones and the muscles as well
Affects women twice as much as men
Most common types are osteoarthritis, rheumatoid arthritis, and gout 2
G out :G out Increase in uric acid and formation of crystals in the tissues and joint of the body
Clinical manifestations:
Affected joints appear dusky, cyanotic
Inflammation of great toe may be first clinical sign
Acute episodes usually brought on by precipitating factors (i.e. trauma, surgery, alcohol ingestion, or systemic infection
Severity is variable
Fever
Clinical course may consist of infrequent mild attacks or multiple severe episodes
Diagnostic Studies :Diagnostic Studies Serum uric acid levels (not completely diagnostic)
Clinical symptoms (often all used for diagnosis)
Synovial fluid aspiration
Family history of gout
24 hour urine collection (uric acid levels)
Drug Therapy
NSAIDs
Xanthine oxidase inhibitor
Probenecide (Benemid)
Allopurinol
Corticosteroids
ACTH (acute treatment)
Nutritional Therapy
Dietary restrictions
Alcohol
Food high in Purines (organ meats)
However, drugs can often control gout without dietary restrictions
Nursing Management- G out :Nursing Management- G out Careful handling/Limited movement of joint
Bed rest
Assess joint for pain and monitor for effectiveness of treatment
Educate patient and family on precipitating factors (i.e. excessive caloric intake or overindulgence in purine-containing foods, alcohol, drug use such as diuretics, Niacin, aspirin and major medical events
Maintenance of normal body weight
O steoarthritis (OA) :O steoarthritis (OA) Most common form of joint disease in North America
Over a 100 different types exist
Slowly progressive noninflammatory disorder of the diarthrodial joints
20 million Americans affected
Expected to greatly increase as population ages
Previously identified as degenerative joint disease
K nown to involve formation of new joint tissue in response to cartilage destruction
No longer considered a normal part of aging process
Growing older is a risk factor
Cartilage destruction can begin between ages 20 and 30
Majority of adults affected by age 40
Mostly seen in weight bearing joints
Nursing Management-O A :Nursing Management-O A Exercise programs
Maintain ideal body weight
Apply heat and cold therapy
Scheduled rest periods
Complementary therapies
Acupuncture
Yoga
Massage
Guided imagery
Therapeutic touch
Teach principles of good body mechanics
Correct use of assistive devices
Avoid repetitive activities or activities that put excessive stress on a joint