Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide

Osteoarthritis (Degenerative Joint Disease) This progressive disease of the joints causes slow break down of the cartilage (articular) within the joints. The cartilage breaks down and does not regenerate itself. The loss of cartilage reduces the movement within the joint and causes painful swelling and lack of mobility. There are two different types: primary idiopathic and secondary osteoarthritis. In idiopathic, there is no known cause. Secondarymay occur from repetitive use injuries, age progression, obesity, genetics, and autoimmune diseases. Osteoarthritis usually starts in the proximal interphalangeal joints in the fingers and proceeds to the hips and knees. It may also only affect one joint or many joints in the body. Signs and symptoms of osteoarthritis: • Pain in the joints • Limited mobility • Neurological deficits • Stiff joints • Muscle spasms • Contractures Nursing assessment for osteoarthritis: • Check pain scale and which joints pain is located in; how long has pain beenpresent • Health and family history: genetics, obesity, age of patient, and decreased muscle strength are all contributing factors to this disease • Physical assessment of joints, mobility, range of motion, and check for crepitus • Check for Heberden’s and Bouchard’s nodes near joints. o Heberden’s nodes: Located at the distal interphalangeal joints o Bouchard’s nodes: Located at the proximal interphalangeal joints • Inquire about support system at home: someone to help with ADLs and emotionaladjustments • Review laboratory and radiology reports: o CT scan: Can diagnose arthritis in the vertebrae o X-ray: Can show inflammatory changes in the joints o Bone scan: Shows increased uptake in bones near affected joints o Synovial fluid analysis: Can check for inflammation and cause; rheumatoid vs. idiopathic Nursing diagnosis for osteoarthritis: • Increased pain related to joint degeneration and muscle spasms • Immobility related to joint dysfunction and pain • Self-care deficit related to immobility and pain • Disturbed body image related to joint appearance changes • Knowledge deficit related to disease process, medications, and self-management

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