Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide Nursing interventions for osteoarthritis: • Give medications per MD order: o Pain medications: Narcotics are used to help relieve initial pain and then management is attempted with regular acetaminophen or aspirin. o Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) are used to reduce inflammation and pain and take about two weeks to become effective. Side effects include stomach upset. Remind patient to take with food. o Corticosteroids: Prednisone or other steroids can be injected into the joint or taken orally to help reduce acute inflammation. Side effects include excess hunger, mood swings, and bone loss. • Prepare patient for possible surgery (Pre-Op): o Joint replacement/arthroplasty: A common treatment for joints that have completely lost all cartilage where the joint is replaced with an artificial version. o Arthroscopy: Exploratory surgery and minor repair of a joint. o Joint fusion (arthrodesis): This procedure actually fuses the bones on either side of a joint together, eliminating the joint but relieving the pain and discomfort. It does result in permanent immobility of the joint, but weight bearing is improved. This procedure is most commonly done on vertebrae. • Give Post-op care and teaching: ambulation, use of walker, breathing exercises, and use of medications. o Hip arthroplasty: These patients require specialized post-op care; use an abduction pillow, never over flex the hips, use a toilet seat riser, use a trapeze in bed for positioning, never turn the patient onto the side of surgery, use pillows for positioning, and never allow legcrossing. o Knee arthroplasty: Continue to use compression stockings until MD states they can be removed, elevate leg, use ice for pain and swelling, keep immobilizer in place, and never allow weight bearing until surgeon orders. • Provide good skin and wound care • Encourage rest and elevation of affected joints • May use heat to affected joints with MDorder • Encourage healthy diet and obtain dietary consult if osteoarthritis is due toobesity • Assist with range of motion when pain is stable; teach isometric exercises for strength • Encourage patient to attend swim class or use a Jacuzzi/whirlpool bath • Refer to medical supply for supportive items: shower bench, walker, crutches, cane, etc. Expected outcomes for osteoarthritis: • Patient able to maintain self-care and mobility with assistive devices • Patient remains free from surgical complications • Demonstrates/verbalizes pain control

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