OA Osteoarthritis Flashcards
(52 cards)
1
Q
Osteoarthritis
A
- DJD (Degenerative Joint Disease)
- Non-inflammatory disorder of mobile joints
- Characterized by breakdown in cartilage
2
Q
Osteoarthritis is the most common…
A
form of joint disease in US
3
Q
Most significant risk factor for osteoarthritis
A
age
-normal process of aging due to wear and tear on joint
4
Q
Percentage of affected adults by osteoarthritis
A
greater than 90% by age 40
5
Q
What gender is more affected by osteoarthritis after age 50
A
women are more affected after 50
6
Q
How many people are symptomatic over 65 years old?
A
60%
7
Q
Types of Osteoarthritis
A
- Primary
2. Secondary
8
Q
Primary Osteoarthritis
A
- idiopathic (no known cause)
- localized vs. general
9
Q
Secondary Osteoarthritis
A
-identifiable cause or predisposition
- repetitive movement
- physical stress
- obesity
- certain occupations
10
Q
What gender is more affected by osteoarthritis before 45
A
men more affected before 45
11
Q
Male osteoarthritis differences
A
- more affected before 45
- knee OA is more common before 45
- Hip OA is more common after 55
- Hip, Knee, spine
12
Q
Female osteoarthritis differences
A
- affected twice as often as men after 45
- knee OA more common after 45
- joints in fingers and thumb base more common after 55
- Hip, knee, hands
13
Q
Describe cartilage during osteoarthritis
A
- damaged
- dull, yellow, and granular
- thins/erodes
14
Q
What happens to the joint during osteoarthritis?
A
- deteriorates
- spurs develop at joint margins
- joint anatomy changes
- interferes with function, decreases mobility
- underlying bone is exposed
15
Q
Prevention of OA
A
- maintain ideal weight
- control blood sugar
- regular moderate exercise
- maintain proper posture
- maintain body alignment
- rest when discomfort noted
- seek treatment early
16
Q
Diagnostic Studies for OA
A
- xray
- MRI
- Bone Scan
- CT
- ESR
- Fluid aspiration
17
Q
What do xrays show for OA patients?
A
- joint narrowing
- spurs
18
Q
Joint fluid aspirate is used to detect…
A
- presence of bacteria (infection)
- uric acid crystals (gout)
19
Q
Nursing assessment
A
- fam hx
- OLDCARTS-P
- pain
- activity level
- mobility
- physical apperance
- dx tests
20
Q
OLDCARTS-P
A
- onset
- location
- duration
- character
- aggravating/relieving
- radiation
- timing
- severity
- prior
21
Q
Nursing diagnoses
A
- chronic pain
- impaired physical mobility
- sedentary lifestyle
- imbalanced nutrition
- dressing self care deficit
22
Q
Implementation of nursing process
A
- decrease pain
- increase mobility
- encourage weight loss
- assistive device
23
Q
evaluation of nursing process
A
- routine assessment
- monitor changes
24
Q
Management of osteoarthritis
A
- no cure
- interdisciplinary
- control of pain and inflammation
- prevention of disability
- improvement of joint function
25
Non-invasive management
- rest and joint protection
- heat for stiffness
- ice for acute exacerbation
- weight reduction
- complimentary/homeopathic therapies
- PT
26
complimentary/homeopathic therapies
- acupuncture
- yoga
- massage
- glucosamine and condroitin
27
PT for osteoarthritis
increases strength and flexibility
28
Pharm therapies for mild to moderate pain
Non-opioid analgesics
- NSAIDs
- Topical gels/cream
29
Typical non-opioid analgesics cream for OA
Capsalcin cream
30
Pharm therapies for moderate to severe pain
- Salicylates
- NSAIDs
- Corticosteroids
- Opioid Analgesics
31
Major joints for surgical intervention
hips and knees
32
Purpose of surgery for OA
- improves function
- corrects deformity
- remove damage
- relieves pain
33
Types of surgery
- joint arthroplasty
- joint resurfacing
- joint irrigation
- joint fusion
- osteotomy
34
Cemented Hip Arthroplasty (HA)
bonds bone to bone
| -can become loose and require revision
35
Cementless Hip Arthroplasty (HA)
long-term stability
-for patient with high activity level and life expectancy >25 yrs
36
Risks of Hip Arthroplasty
- infection
- clots
- joint breakdown
37
Pre-op nursing care for Total Hip Arthroplasty
- establish data base
- reassurance regarding pain relief
- explain and practice post-op activities
- PT consult
- Fit for support hose
38
how to establish data base
amount of pain and disability
39
post-op activities
- turn, cough, and deep breathe
- isometric exercises of quads and glutes
- dorsiflexion and plantar flexion of foot
40
isometric exercises
no joint movement
41
PT consult
- use of trapeze
| - exercises
42
Support hose for THA patients
- helps prevention for thrombophlebitis
- wear for 6-8 wks
- use along with anticoagulants
43
Post-op nursing care for THA
- take measures to prevent infection
- assess dressing, drainage tubes, and VS
- early ambulation
- maintain correct positioning
- watch for signs of dislocation
44
Measures to prevent infection after THA
- educate client about S/S of infection
- antibiotics after new joint
- prophylactic antibiotics before dental procedure
- strict asepsis during dressing change and when emptying any drains
45
Assessing the dressing & drainage tubes
- expect 200-500cc drainage in 1st 24 hrs
| - expect 120cc by 48 hrs
46
Early ambulation after THA
- 1st post op day
- with walker and PT for cemented
- partial weight bearing for non-cemented
47
Correct positioning for post-op THA
- do not cross legs
- no adduction or rotation
- hip flexion not to exceed 90 degree for 4-6 weeks
- turn toward unaffected side/use brace
- help with socks and shoes
- use elevated toilet seat
48
Signs for dislocation
- groin pain on movement
| - deformity or external rotation
49
Total Knee Arthroplasty (TKA)
replacement of knee joint due to unremitting pain and/or instability of joint
50
Pre and Post op care for TKA
-similar to THA except do not use abduction pillow or brace
51
Post-op care for TKA
-(CPM) Continuous passive motion machine
52
CPM
- range per minute ordered by surgeon
- 8-20 hrs/day
- prevents scar tissue
- positioned incorrectly can cause damage
