Flashcards in Quiz #3 Deck (35):
Inflammatory vs Noninflammatory Joint Disease is differentiated by
Absence of synovial membrane inflammation, lack of systemic s/sx, normal synovial fluid analysis
Degenerative joint disorder with a progressive loss of articular cartilage accompanied by new bone formation and capsular fibrosis, usually affects weight bearing joints (hands, elbow, feet) and variable degrees of synovitis and thickening of the joint capsule
Name some of the manifestations of OA
Pain, stiffness, enlargement of the joint, tenderness, limited motion, and deformity
What are some of the goals of therapy for OA?
Early elimination of risk factors, early diagnosis, surveillance of the disease, appropriate treatment of pain and maximize/encourage mobility
What is crepitus?
Continuous grating sensation caused by irregular cartilage, may be felt or heard as the joint is put through passive ROM
What is the primary drug of choice for pain relief of OA? What are the risks?
Acetaminophen/Risk for liver damage if pt takes >4,000mg QD, have concurrent alcoholism, or have pre-existing liver disease
This OTC topical salicylate is useful for some pts as a temporary pain reliever. How does it work?
Aspercreme. It works by blocking substance P, a neurotransmitter for pain
If acetaminophen or topical agents are not successful, what else can be used?
NSAIDs, work by inhibiting COX-1 and COX-2. COX-2 manages pain and inflammation w/ fewer side effects of GI distress/bleeding
What are some of the nursing issues for a pt with OA?
Mobility, pain, risk for injury (falls, surgical complications/medication toxicity), pre-op care and post-op care
This connective tissue disease is one of the most common and is the most destructive to the joints. It is a chronic, progressive, systemic inflammatory AI disease that primarily affects the synovial joints
Rheumatoid factors consist mainly of what two immunoglobulins?
IgG and IgM
Early systemic clinical manifestations of RA include
Low grade fever, fatigue, weakness, anorexia, and paresthesias
Treatment of RA includes
Salicylates, NSAIDS (COX-2), Ibuprofen and Celebrex
These types of drugs can be prescribed to slow the progression of mild rheumatoid disease before it worsens
DMARDs (Disease modifying antirheumatic drugs)
Name 3 DMARDS
Plaquenil an antimalarial drug, Azulfidine, and Minocycline
Arthritis in older adults is not a normal part of the aging process. T/F
This inflammatory arthritis is caused by deposits of uric acid crystals in the joints
Name five high purine rich foods that cause gout:
anchovies, asparagus, beef kidneys, game meats, liver
Medications that can cause gout include:
Diuretics, salicylate containing drugs, niacin, cyclosporine, and levodopa
Hyperuricemia, presence of uric acid crysals in joint fluid, more than one attack of acute arthritis, arthritis that develops in a day, attack only in one joint
S/Sx of gout
Treatment for gout includes
NSAIDS, corticosteroids, colchicines, and allopurinal
What is dislocation?
Temporary displacement of two bones, loss of contact between articular cartilage
Contact between articular surfaces is only partially lost is called
Dislocation and subluxation are associated with
Fractures, muscle imbalance, rheumatoid arthritis, or other forms or joint instability
Muscle fiber shortening without an action potential and caused by failure of the sarcoplasmic reticulum even with available ATP is called
What is stress induced muscle tension?
Neck stiffness, back pain, clenching teeth, hand grip, headache, and is associated with chronic anxiety
Reduction in the normal size of muscle cells d/t prolonged inactivity (bed rest, trauma, casting or nerve damage) is called
Treatment of disuse atrophy is
Isometric movements and passive lengthening exercises
Sudden, forced motion causing the muscle to become stretched beyond its normal capacity, local muscle damage, and can involve muscle tendons is
What treatment is used for muscle strains?
RICE - rest, ice, compression and elevation
The most common cause of toxic myopathy is
What is myositis ossificans?
Complication of local muscle injury, inflammation of muscular tissue with subsequent calcification and ossification of the muscle
This is an acute problem, life threatening complication of severe muscle trauma with muscle cell loss (crush/compartment syndrome)
The difference of RA and juvenile RA is
the mode of onset; arthritis in fewer than five joints, more than five joints, and systemic disease