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kol- Med Surg 320 Spring > OsteoArthritis > Flashcards

OsteoArthritis Flashcards

1
Q

what is osteoarthritis?

A

degenerative joint disease

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2
Q

what body parts is OA most common in?

A

hips, knees, spine, hands

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3
Q

patho of OA

A
  • wearing down of cartilage in joints resulting in bone on bone
  • –> friction of bones as cartilage wears down
  • –> formation of bony spurs (osteophites?) as a result of increased osteoblastic activity
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4
Q

primary causes of OA

A
  • Aging

- Genetics

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5
Q

secondary causes of OA

A
  • Joint Injury (Occupational and Repetitive exercise)
    • Obesity
    • Trauma
    • Overuse
    • Diseases
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6
Q

characteristics of OA

A
  • chronic joint pain and stiffness that worsens after activity and diminishes with rest
  • limited ROM with pain or crepitus
  • enlarged/hardened joints
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7
Q

Heberden’s Nodes vs Bouchard’s Nodes:

A

Heberden’s Nodes: boney nodules at distal interphalangeal joint
Bouchard’s Nodes: boney nodules at proximal interphalangeal joint

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8
Q

diagnostics for OA

A

Based on History and Physical Examination
X-rays may show degenerative changes
MRI and CT for vertebral and knees
Erythrocyte sedimentation rate and hs-C reactive protein (synovitis)(generalized inflammatory markers)

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9
Q

pain management interventions for OA….what is last resort?

A
  • Tylenol
  • Lidoderm patches
  • Other topical medications
  • NSAIDS
  • Topical NSAIDS
  • Muscle Relaxants
  • Opioids - last resort, use if waiting for long term fix like surgery, not itself a long term solution
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10
Q

is there a cure for OA?

A

no!

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11
Q

other interventions for OA pain management??

A
  • Exercise and Rest balance
  • Hot or cold therapy (focus on heat)
  • Weight control
  • Supplements
    • Glucosamine
    • Chondroitin
  • Position
  • Shoes
  • Surgery
  • PT/OT
  • Swimming, Walking, Cycling, Aerobics
  • Home Adjustments
  • Beware of curative remedies
  • -> nothing cures it
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12
Q

surgery for OA

A

total joint arthroplasty/replacement

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13
Q

total joint arthroplasty/replacement- when do we do it and what is it?

A

= surgical creation of joint

  • Indicated:only when QOL can no longer be maintained
  • Majority of patients are >60
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14
Q

most common joint for arthroplasty/replacement?

A

knee

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15
Q

contraindications for arthroplasty?

A

Infection, Advanced osteoporosis, Severe inflammation, Severe diabetes/dialysis

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16
Q

preoperative considerations for arthroplasty

A
  • Acquire equipment - walker, place to sleep downstairs, skilled nursing facility?
  • Clean entire body with an antibiotic soap: a few days before surgery consecutively
  • Blood transfusions
  • Pre-operative Antibiotic
  • NPO after midnight
17
Q

education about dental procedures w/ arthroplasty

A

take prophylactic antibiotic before dental procedure with hardware

18
Q

2 parts affected in hip arthroplasty

A

acetabulum and femoral

19
Q

2 parts affected in knee arthroplasty

A

femur/tibia

20
Q

cement vs fit press

A

Cement = immediately held together = weight bearing immediately –> more likely to happen in older person
Press Fit= osteoblastic activity has to occur for security, takes time! = NWB after surgery

21
Q

post op hip athroplasty complications

A

-dislocation
-WB vs NWB
–DVT/ PE
-Infection
-Bleeding
-Neurovascular Compromise
-Assess? –> CMS (circulation, motion, sensation)
circulation = pulses, perfusion
motion = movement
sensation = feel it
Hip Arthroplasty: Precautions
-knees @ 90 angle
-do not bend/cross legs
-Abduction pillow = for posterior approach only
- use for elderly with confusion

22
Q

CMS assessment

A

CMS (circulation, motion, sensation)
circulation = pulses, perfusion
motion = movement
sensation = feel it

23
Q

Hip Arthroplasty: Precautions

A
  • knees @ 90 angle
  • do not bend/cross legs
  • Abduction pillow = for posterior approach only
    • use for elderly with confusion
24
Q

only use abduction pillow with

A

posterior hip approach / elderly w/ confusion

25
Q

post op knee considerations

A

-Continuous Passive Motion machine: settings based on provider order- continuous motion of joint, store on chair- not on floor
-Ice
-Pressure dressing
-Prevention of adduction is not necessary
-Keep in neutral position (avoid hyperextension and rotation)
-DVT/PE, Bleeding, Infection, NV Compromise
AMBULATE!

26
Q

-Continuous Passive Motion machine, settings are based on

A

provider order!

27
Q

signs of dislocation

A

severe pain, shortening of the leg, leg rotation

kol- Med Surg 320 Spring (43 decks)

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