Osteoartritis

Osteoartritis
By:
Rizalyn Dumanais
Osteoarthritis (Degenerative
Arthritis or Degenerative Joint
Disease)
• It is the most common form of
arthritis.Derived from the Greek
word "osteo", meaning "of the
bone", "arthro", meaning "joint",
and "itis", meaning inflammation,
although the "itis" of osteo
arthritis is somewhat of a
misnomer—inflammation is not a
conspicuous feature.Metabolic
disorder characterized by loss of
bone mass, increased bone
fragility and an increased risk of
fracture.Degeneration and
progressive softening and loss of
cartilage leading to formation of
new bone at cartilage lining.
 Causes
• Primary osteoarthritis - a normal part of
aging, results from many things, including
metabolic, genetic, chemical, and
mechanical factors
• Secondary osteoarthritis - usually follows
an identifiable predisposing event- most
commonly trauma, congenital deformity, or
obesity- and leads to degenerative changes
 Risk Factors

 Age
 Weight
 Genetics
• Signs and Symptoms
• The most common symptom of osteoarthritis
is a deep, aching joint pain, particularly
after exercise or wait bearing, usually
relieved by rest. The symptoms include
• Aching during changes in weather
• Limited movement.
• Pain aggravated by use and relieved by rest.
• Decreased ROM, crepitus
• Bourchard’s- bony overgrowth at the proximal
interphalangeal joints.
• Swelling
• In smaller joints, such as at the fingers, hard bony
enlargements, called Heberden's nodes (on the distal
interphalangeal joints) and/or Bouchard's nodes (on the
proximal interphalangeal joints), may form, and though they
are not necessarily painful, they do limit the movement of
the fingers significantly. OA at the toes leads to the
formation of bunions, rendering them red or swollen
Diagnostic Procedures

• Blood test
• X-rays
• Arthrocentesis
• Arthroscopy
 Treatment
• Treatment generally involves a combination of exercise,
lifestyle modification and analgesics. If pain becomes
debilitating joint replacement surgery may be used to
improve the quality of life.
• Arthroplasty: (partial or total): replacement of
deteriorated part of joint with prosthetic appliance.
• Osteoplasty: scrapping and lavage of deteriorate bone from
joint.
• Osteotomy: change in alignment of bone to relieve stress by
excision of wedge of bone or cutting of bone.
• Acetaminophen; nonsteroidal anti-inflammatory drugs
(NSAIDs) if joint symptoms persist.
 Nursing Management/Health
Teachings
• If the patient needs surgery, provide appropriate preoperative and
postoperative care.
• Provide emotional support and reassurance to help patient cope with limited
mobility.
• Assess joints for pain and ROM.
• Encourage to have adequate rest.
• Encourage asked for assistance when moving, and encourage to perform gentle.
• Teach the patient to avoid overexertion. He or She should take to stand and
walk correctly, to minimize weight-bearing activities, and to be especially
careful when stopping and picking up objects.
• Advise the patient to always wear well-fitting supportive shoes; don’t allow the
heels to become too worn down.
• Tell the patient to install safety devices at home, such as guard rails in the
bathroom.
• Instruct the patient to take medication exactly as prescribed, and report
adverse reaction immediately
Gouty Arthritis (Gout)- a.k.a as podagra

 Gout is condition that

results from crystals
of uric acid depositing
in tissues of the body.
Gout is characterized
by an overload of uric
acid in the body and
recurring attacks of
joint inflammation
(arthritis). Uric acid is
a breakdown product
of purines that are
part of many foods we
eat.
 An abnormality in handling uric acid can cause
attacks of painful arthritis (gout attack), kidney
stones, and blockage of the kidney filtering tubules
with uric acid crystals, leading to kidney failure.
Gout has the unique distinction of being one of the
most frequently recorded medical illnesses
throughout history. Gout is nine times more common
in men than in women. It predominantly attacks
males after puberty, with a peak age of 75. In
women, gout attacks usually occur after menopause.
Among the male population in the United States,
approximately 10% have elevated blood uric acid
levels, a condition known as hyperuricemia. However,
only a small portion of those with hyperuricemia will
actually develop gout. If your parents have gout,
then you have a 20% chance of developing it
 Causes
 Hyperuricemia is the underlying cause of
gout. This can occur for a number of
reasons including dietary, genetic, or
underexcretion of urate, the salts of uric
acidAbout 10% of people with
hyperuricemia develop gout
 Risk factors
 Age
 Diet
 Lead Exposures
 obesity,
 excessive weight gain, especially in youth,
 moderate to heavy alcohol intake, high blood
pressure, and
 abnormal kidney function.
 Certain drugs and diseases can also cause
elevated levels of uric acid.
Signs and Symptoms
 Joint pain, redness, heat, swelling; great/big toe
and ankle are most commonly affected.
 Headache, malaise, anorexia.
 Tachycardia, fever, tophi In the great toe, outer
ear, hands and feet.
Complications
 Kidney stones
 High Blood Pressure
 Congestive Heart Failure
Medical and Surgical Managements

 Immobilization and protection of the inflamed,

painful joints; local application of heat and cold.
 Give analgesic to relieve pain
 Continuity maintenance of allopurinol to control
uric acid level.
 In some cases, surgery may be necessary to
improve joint function or correct deformities,
tophi must be excised and drained if they
become infected or ulcerated
 Nursing Management/Health
Teachings
• Maintain a fluid intake of at least 2000 to 3000ml. a day to avoid
kidney stones.
• Instruct client to avoid alcohol and caffeine. These products can
increase uric acid level.
• Avoid purine- rich foods (caffeine, alcohol, organ meats, sardines,
salmon, scallops and gravy).
• Instruct client to avoid large doses of vitamin C while taking
Allupurinol to prevent kidney stones.
• Instruct client to take drugs with food. to prevent GI irritation.
• Advice client to have yearly eye examination. Visual changes can
occur from prolonged used of allopurinol.
• Observe for the side effects of anti gout medications like
headache,nausea, vomiting, bone marrow depression skin rash,
kidney stone, metallic taste
 Rheumatoid Arthritis
It is a chronic, systemic inflammatory disorder that
may affect many tissues and organs, but
principally attacks synovial joints. Autoimmune
diseases are illnesses that occur when the body
tissues are mistakenly attacked by its own immune
system. Because it can affect multiple organs of
the body, rheumatoid arthritis is referred to as a
systemic illness and is sometimes called
rheumatoid disease. While rheumatoid arthritis is a
chronic illness, meaning it can last for years,
patients may experience long periods without
symptoms. Typically, however, rheumatoid arthritis
is a progressive illness that has the potential to
cause joint destruction and functional disability
 Causes
The cause of rheumatoid arthritis is unknown. Even
though infectious agents such as viruses, bacteria,
and fungi have long been suspected, none has been
proven as the cause. The cause of rheumatoid
arthritis is a very active area of worldwide research.
Some scientists believe that the tendency to develop
rheumatoid arthritis may be genetically inherited. It is
suspected that certain infections or factors in the
environment might trigger the immune system to
attack the body's own tissues; resulting in
inflammation in various organs of the body such as
the lungs or eyes. Environmental factors also seem to
play some role in causing rheumatoid arthritis.
Recently, scientists have reported that smoking
tobacco increases the risk of developing rheumatoid
arthritis.
 Risk factors
Being Female: -Women are affected 2 to 3
times more than men.
Ages 40 to 60: -It often begins at
adulthood.
Poor Diet and lifestyle: -Can hasten the
development of arthritis.
Environmental Factors
Genetic Predisposition: -May affect on how
the immune system functions causing
inflammation and eventual destruction of
the membranes that line the joints
 Signs and Symptoms
Fatigue, anorexia, malaise, weight loss, slight temperature
elevation,
Painful, warm, swollen joint with limited motion, stiffness in
the morning and after periods of inactivity( non- use of
joints).
Cripping deformity in long standing disease.
Muscle weakness secondary to inactivity.
Some patients have other manifestations: subcutaneous
nodules, eye, vascular, lung or cardiac problems.
Sjogren’s syndrome is characterized by:
Excessice dryness of the eyes, mouth and vagina.
Felty’s syndrome is characterized by:
Luekopenia (causes low resistance to infection)
Splenomegaly (causes hemolutic anemia because trapped
RBC’s in the spleen undergo hemolysis).
Nursing Management/ Health
Teachings
Encourage to do passive ROM exercises of
joints. To prevent contractures.
Apply splint painful joints.
Encourage to have adequate rest
Apply hot and cold compress
Warm bath in the morning. To relieve
morning stiffness.
Protect the client from infection.
Provide well balanced diet.
Encourage physical therapy as prescribed
THANK YOU!!!!