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NURS 193 [FINAL] > Osteoarthritis & Gout & Osteoporosis > Flashcards

Osteoarthritis & Gout & Osteoporosis Flashcards

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1
Q

What is Osteoarthritis (Degernatiev Joint Disease)?

Is Osteoarthritis Curable or Incurable?

A
  • noninflammatory, localized joint disorder caused by the progressive deterioration and loss of articular cartilage and underlying bone, primarily in weight-bearing joints.
  • Incurable
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2
Q

What side of teh body does Osteoarthritis affect?

What joints are affected by Osteoarthritis?

A

affects body:

  • unilaterally

Joints Affected:

  • Spine
  • Hips
  • Knees
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3
Q

What population does Osteoarthritis affect?

A
  • Older Adults: > 60
  • More likely in women
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4
Q

What are Risk Factors for Osteoarthritis? How do they contribute to Osteoarthritis?

A

Age

  • → more common in older adults

Joint Injury

  • → joint stress → ⬆ risk of osteoarthritis

Chronic joint dz

  • → RA → ⬆ risk of osteoarthritis

Obesity

  • → excess strain/pressure on joints

Diabetes

  • → ⬆ risk of osteoarthritis
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5
Q

What are Clinical Manifestations of Osteoarthritis?

A
  • Morning stiffness last < 1 hr in the morning or after sitting for extended periods
    -> ⬇ROM
  • Localized joint pain
    -> after movement/high activity levels
  • Crepitus
  • Heberden and Bouchards nodules: hard bony lumps surrounding finger joints
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6
Q

What Diagnostic Procedures are used to diagnose Osteoarthritis?

A

Hx, Course & Physical Examination

Labs

  • No definitive labs
    -> used to screen for associated dz

Radiology

  • X-Ray (BEST)
    -> used to determine the structureal joint changes and show serverity of disease
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7
Q

Treatment for Osteoarthritis

What are the goals fo treatment of Osteoarthritis?

A

decrease tenderness with pressure, pain at rest and motion, night pain, stiffness/swelling, improved range of motion

basically manage SXS & slow disease progression

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8
Q

Treatment for Osteoarthritis

In regards to Osteoarthritis, what drug therapies can be utlizied?

A

Non opioid analgesic

  • APAP (primary medication for OA)
  • Tramadol
  • ASA
  • Steroids
  • NSAIDs

Opioid analgesic

  • Oxycodone
  • Codiene

Intra-articular injection

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9
Q

Treatment for Osteoarthritis

In regards to Nonopioid Analgesics, what is the primary drug of choice for pain?

How many grams of this medication should NOT be exceeded in a day? Why?

What beverage should be avoided with this medication?

A

Primary Drug:

  • Acetominophen (APAP)

Limit:

  • 4g/day
    -> risk of hepatotaxicity

Beverage to Avoid:

  • Alcohol
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10
Q

Treatment for Osteoarthritis

In regards to Nonopioid analgesics, briefly describe the properties of tramadol?

A

Weak opioid properties

  • combined with APAP
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11
Q

Treatment for Osteoarthritis

In regards to Nonopioid analgesics, what sxs can ASA cause at high doses?

A
  • GI bleeds
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12
Q

Treatment for Osteoarthritis

In regards to Nonopioid analgesics, what are Steroids used for?

A
  • short-term use for pain relief and inflammation
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13
Q

Treatment for Osteoarthritis

In regards to Nonopioid analgesics, what are NSAIDs used for? What SXS/Complications can come from NSAIDs?

A

Help w/ inflammation

  • can cause GI bleeds & Renal Failure
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14
Q

Treatment for Osteoarthritis

What are some examples of OTC NSAIDs?

What are some examples of perscription NSAIDs?

What education should be given to pts about taking NSAIDs?

A

OTC:

  • Ibprofen (Advil)
  • Ketoprofen
  • Naproxen

Perscription:

  • Diclofenac (Voltaren)
  • Celebrix: (Cox-2 inhibitor): No GI irritation

Education:

  • Take NSAIDs w/ food (and proton pump inhibitor)
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15
Q

Treatment for Osteoarthritis

In regards to Opioid Analgesics to treat Osteaoasrthtis, what are they used for?

A

short term pain relief

  • due to tolerance and dependance risk
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16
Q

Treatment for Osteoarthritis

In regards to Intra-articular Injections for Osteoarthritis treatment, what is the reasoning behind getting this medication?

Who might the Intra-articular injection benefit?

A

Reasoning:

  • with osteoarthritis → lower levels of hyaluronic acid in joints
  • Intended to replace the lost hyaluronic acid → reducing SXS

Benefit:

  • pts who cannot take NSAIDs or Analgesics
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17
Q

Treatment for Osteoarthritis

In regards to Intra-articular Injections, what are soem potential side effects?

Which patietns would be contraindicated against Intra-articular Injections?

A

Side Effects:

  • mild pain
  • swelling bruising
  • redness
  • rash/itching

Contraindication:

  • People with Skin Disease
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18
Q

Treatment for Osteoarthritis

The following below are nonpharamcologic methods that can be used for Osteoarthritis treatment. Why are these methods used?

  • Heat Therapy
  • Cold Therapy
  • Massage
A

Heat Therapy:

  • relax muscels, reduce pain/stiffness
    -> use temp just above body temp to avoid burns

Cold Therapy:

  • Numb nerve ending & reduce inflammation

Massage:

  • Reduce pain/stiffness in affected joints
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19
Q

Treatment for Osteoarthritis

Elaborf the Menace was recently diagnosed with Osteoarthritis. She needs her joints to continue working in her particular profession? What surgery options does she have to help with her Osteoarthritis?

Study These Flashcards
A

TOLD JA

Total Joint Irrigation

  • flush out joint to reduce inflammation & debris

Osteotomy

  • cut and realign bone to shift weight off dmg cartilage

Laproscopic Surgery

  • remove bone spurs

Debridement

  • remove dmg cartilage

Joint Replacement/Total Joint Replacement

  • dmg joint replaced with artifical joint

Arthroscopic Surgery

  • small camera used to see and clean joint
20
Q

Interventions for Osteoarthritis

Wendi the Frog recently got diagnosed with Osteoarthritis. What type of dietary changes should she make for her condition?

Study These Flashcards
A

Eat healthier & lose weight (reduce body weight by 10%)

  • pvt obesity & pressure on weight-bearing joints
21
Q

Interventions for Osteoarthritis

Derb the Bird was recently diagnosed with OSteoarthritis. He is quite the active little fella, but needs to be educated on the type of exercise he can do? What education should be provided to Derb about exercise?

Study These Flashcards
A
  • low impact exercises: 30 mins/day : maintain joint mobility and strength
    -> walking
    -> swimming
    -> cycling.
  • PT/OT
    -> improve/monitor ADLs
22
Q

Interventions for Osteoarthritis

Bronkus the Bulldog recently got diagnosed with Osteoarthritis. What lifestyle changes can he do to help with his Osteoarthritis?

Study These Flashcards
A

Use Assitive Devices:

  • help w/ mobility & ADLSs
    -> Canes, Walkers

Practice Ergonomics:

  • Maintain good posture
    -> reduce strain on vertebral column
23
Q

What is the most common type of arthritis that is characterized by the breakdown of cartilage, leading to joint pain, stiffness, and limited mobility?

Study These Flashcards
A

Osteoarthritis

24
Q

What is Gout?

Is Gout Curable or Incurable?

Study These Flashcards
A
  • Systemic metabolic disease where uric crystals deposit into joints causing inflammation and severe pain
  • ONLY curable for of arthritis
    -> b/c you can limit uric acid in the body and reverse its SXS
25
What is **Primary Gout** caused by? | MOST COMMON TYPE OF GOUT
- caused by **hereditary/genetic** error in **purine metabolism** causing increased uric acid production compared renal excretion -> sodium urate depositired in synovial tissues | MOST COMMON TYPE OF GOUT
26
What is **Secondary Gout** caused by? | Provide some examples of causes
- caused by increase hyperuricemia due to dz or medication -> ex: renal insufficiency, diuretic medication, cancer, chemotherapy
27
What side of the body does **Gout** affect? What joitns are affected by **Gout**?
**Affects Body:** - Usually Unilateral -> rarely be bilateral **Joints Affected:** - Smaller joint in the body -> ESPECIALLY Great toe
28
What population does **Gout** affect?
- more likely in men 30-50 - post-menopausal women
29
What are **Risk Factors** for **Gout**?
- Family Hx - High purine diet
30
What are **Clinical** **Manifestations** in **Acute Gout**? What are **Clinical** **Manifestations** in **Chronic Gout**?
**Acute Gout:** - Suddent onset: -> 1st attack -pain/inflmmation in Great toe **Chronic Gout:** - repeated attacks w/ remission and exacerbation episode - tophaceous deposits uric crystals in pinna, arms, fingers, toes - kidney stones
31
# Diagnositc Procedure for Gout What **Diagnostic Procedures** are used to diagnose **Gout?**
**Hx & Physcial Exam** **Labs** - Blood Draw - Renal FUnciton Lab - Arthrocentesis/Joitn Aspiration
32
# Diagnositc Procedure for Gout In regards to **Labs** for **Gout**, what labs are utilized and what do they assess/mean?
**Blood Draw:** - serum uric acid > 8 mg/100 ml **Renal Function Lab:** - ⬆ BUN/Creatinine - ⬆ Urinary Uric Acid **Arthrocentesis/Joint Aspiration:** - Positive for Uric Acid Crystals
33
# Treatment for Gout What **Drug Therapy** is used for **Acute Gout**? What are they use for? What **Drug Therapy** is used for **Chronic Gout**? What are they used for?
**Acute Gout:** - Colchicine/NSAIDs -> reduce inflammation **Chronic Gout:** - Allopurinol, Probenecid, Indomethacin -> promote urice acid excretion
34
# Treatment for Gout Some **medications/drinks** can cause **increased** levels of **uric acid levels** in the blood and must be **avoided** if a patient has **Gout**. What **medications/drinks** shuld be avoided?
- Aspirin - Diuretics - Alcohol
35
# Interventions for Gout Gordon the Scuba Shark recently got diagnosed with **Gout**. What **dietary educatrion** should be provided to Gordon?
**low purine diet:** - avoid red/organ meat or shellfish **increase fluid intake and urinary ph**: - pvt kidney stones - avoid low fat milk, coffee, citrus juices, colas
36
What is **Osteoporosis**? What is it **also known as**? Why?
- **chronic metabolic disease** of cellular regulation in which bone loss causes significant decreased density and possible fractures **AKA: Silent disease** - progresses without noticeable SXS b4 fracture occurs
37
What is the **Pathophysiology** of **Osteoporosis**?
- bone minerals are reabsorbed into circulation due to need - breakdown/reabsorption is faster than bone formation - weakened bone matrix - bones become: porous, brittle and weak -> fractures occur easily
38
# Etiology of Osteoporosis What are **lifestyle causes** of Osteoporosis?
- Postmenopause ->Estrogen/Androgen deficiency - inactivity/Decreased mobility - Low Lean Body Mass - Smoking -> active/passive
39
# Etiology of Osteoporosis What are **dietary causes** of **Osteoporosis**?
- low Ca, Vit. D, Protein - High alcohol/caffeine intake
40
# Etiology of Osteoporosis What **medication use can cause** Osteoporosis?
- Chronic Steroid Use/Therapy
41
# Incidence Who is **Osteoporosis** more likely seen in/affect?
- Common in Women -> menopause -> Hx of total hysterectomy - Euro-Caucasian or Asian ethnicities - Age > 50 - Anorexia - Family Hx - Hx of low trauma fractures - RA
42
What are **Clinical Manifestations** of **Osteoporosis**?
- Bone Fracture -> ⬆ susceptibility: wrist, hip, spine - Loss of Height/Postural Changes -> vertebral compression/collapsed vertebrea (kyphosis) - Chronic Pain -> fractures/collapsed vertebrae - General Weakness/Fatigue
43
# Diagnostic Procedures for Osteoporosis What **Diagnostic Procedure** is used to diagnose **Osteoporosis**?
**DEXA Scan** (hip & spine) - assess bone density **X-Ray**: used to assess bone density
44
# Treatment for Osteoporosis What **Medications and Supplements** can be used to treat **Osteoporosis**?
**Medications:** - **Biphosphonates (Fasomax):** most common -> osteoporosis prevention/treatment - **SERMs: Raloxifene (Evista)**: Mimic Estrogen -> increase bone mineral density & reduce bone resorption - **Hormone Repacement Therapy:** for estrogen - **Parathyroid hormone (Teriparatide):** Build Bone - **Calcitonin** (nasal spray) **Supplements:** - Calcium: 1500 mg/day - Vit D: 1000 units/day
45
# Intervention for Osteoporosis Artic the Warm Penguin was recently diagnosed with **Osteoporosis**. What **exercise** should he implement?
- Actiive ROM -> weight-bearing exercises (walking) - Proper use of Body Mechanics -> prmotes safety/ADLs
46
Mila the Elephant was recently diagnosed with **Osteoporosis**. What type of **dietary educaiton** should be provided to Mila?
**Increase Nutrients for Bone Health:** - Calcium - Vitamin D - Protein
47
T/F: Dimineralization of bone is more prone after menopause
TRUE

NURS 193 [FINAL] (5 decks)

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