Nursing Care and Pathophysiology of Osteoarthritis (OA)

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Nichole Weaver
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Included In This Lesson

Study Tools For Nursing Care and Pathophysiology of Osteoarthritis (OA)

Signs of Osteoarthritis (Mnemonic)
Osteoarthritis Pathochart (Cheatsheet)
Nodes in Osteoarthritis (Image)
Common Sites for Osteoarthritis (Image)
Patho of Osteoarthritis (Image)
Xray of Osteoarthritis (Image)
Osteoarthritis Interventions (Picmonic)
Osteoarthritis Assessment (Picmonic)
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Outline

Overview: Progressive disorder of the articulating joints

Pathophysiology:

Osteoarthritis is caused by the degeneration of the joints. Joints that are used frequently or have to bear more weight are more at risk for the degeneration. A healthy joint has fluid and cartilage. As the joint is used and worn down the fluid and cartilage are decreased. This causes joint degeneration and pain.
The body attempt to repair the join and inflammation occurs.

General:

1. Affects weight-bearing joints and joints that receive a lot of stress: Back, hips, knees, hands, feet
2. Risk Factors: Age, gender, genetics, joint use
3. Stages
a. Mild bone spurs
b. Worsening bone spurs, pain
c. Loss/Damage of cartilage, pain
d. Bone on bone” due to loss of cartilage and synovial fluid

Assessment:

  1. Joint pain relieved with rest

  2. Heberden’s Nodes (distal)

  3. Bouchard’s Nodes (medial)

  4. Difficulty standing up after sitting

  5. Crepitus in joints grating sensation)

Therapeutic Management

  1. Administer Analgesics
  2. Topical agents
  3. NSAIDs
  4. Muscle Relaxants
  5. Corticosteroid injections

 

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Transcript

Okay guys, let’s talk about osteoarthritis. If you break down this word, you can see that this is inflammation (itis) of bones (osteo) and joints (arthro).

Osteoarthritis is also known as degenerative joint disease. It is a progressive disease of articulating joints, which just means any joints that move. It’s most common in weight-bearing joints like the back, hips, and knees, and high stress joints like the hands and feet. It is very unlikely that any of us go a day without frequently using at least one if not all of these joints. Major risk factors for osteoarthritis are age, genetics, and use of the joints, which, again, there really isn’t much we can do about that. We have to function, and we need our joints to do that.

Osteoarthritis varies in stages from stage 1 to 4. Stage 0 is a perfectly normal joint with plenty of cartilage and synovial fluid and no damage to the bones. All the way to stage 4 which involves a loss of cartilage, a loss of synovial fluid and narrowing of the joint, and bone spurs and irritation of the bone itself. Think of it like the tread wearing down on a tire. The more you skid and squeal your tires, the faster the tread gets worn down and the higher the likelihood of a blowout. Just looking at this bone, you can imagine how painful this gets as the patient progresses through the stages of osteoarthritis.

Most of your patients will be being seen by you for some other reason, but they will have osteoarthritis, so we want to know what to look for. First, is that they will have joint pain that is typically relieved with rest. This is one way that we can tell the difference between rheumatoid arthritis and osteoarthritis, is that the pain Pence to be relieved with rest in osteoarthritis, whereas pain in RA is continuous. we will also see the patient develop these nodes on their joints. This is where the bone has been irritated and is trying to repair itself. Specifically in the hands, they’re called Heberden’s nodes and Bouchard’s nodes. The only difference between the two is that Heberden’s nodes affects the Distal joints and Bouchard’s nodes affects the medial joints. I remember this because B – Bouchard’s is closest to the Body. And if you were to point to a guy and say “He did it”, it would be with the end of your finger. Patients will also have trouble standing up after they’ve been sitting for a while. They may moan and groan or just be a little slow standing up because of the pain and stiffness. They’ll also experience crepitus in joints. Crepitus is like a cracking, grating feeling. Patients may feel it, but it can also be heard sometimes. If you ever get a chance to meet me in person, ask to listen to my knees, because they have some pretty epic crepitus. Again, the knees are weight-bearing and high stress joints.

So, what do we do for these patients? Well there are topical analgesics they can use like topical steroids or even lidocaine patches. Even any kind of over the counter muscle or pain relief cream or patch can help. We’ll also give them NSAIDs to decrease inflammation and possibly muscle relaxants to ease any pain or spasming around that joint. The other thing we can do is steroid injections. The doctor will inject a corticosteroid right here into the joint space where the inflammation is. This will help to decrease some of the pain. It’s only temporary, though, so a lot of patients will have to come back for injections every 3-6 months. As with any other type of musculoskeletal injury, we can also do heat/cold therapy and make sure we arrange for periods of rest.

This may be relatively obvious, but our priority nursing concepts for a patient with osteoarthritis are comfort and Mobility. Make sure you check out the care plan attached to this lesson to see more detailed nursing interventions.

So let’s do a quick recap of osteoarthritis. It is a degenerative joint disease that is Progressive and involves a loss of cartilage and synovial fluid, as well as development of bone spurs and irritation of the bones. It most commonly affects high-stress joints and weight bearing joints like the hips, knees, back, hands and feet. Joints will be painful, but relieved with rest, they will have stiffness and possibly crepitus, as well as the potential for heberden’s or Bouchard’s nodes in their hands. We want to give analgesics and anti-inflammatory medications, and provide for frequent rest periods to help alleviate some of their symptoms.

So those are the basics of osteoarthritis. don’t forget to check out all of their resources attached to this lesson to learn more. Now, go out and be your best selves today. And, as always, happy nursing!

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  • Terminology
  • Urinary System
  • Respiratory Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
  • Oncology Disorders
  • Integumentary Disorders
  • Preoperative Nursing
  • Musculoskeletal Trauma
  • Integumentary Disorders
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  • Disorders of the Posterior Pituitary Gland
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  • Labor Complications
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  • Disorders of Pancreas
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  • Intraoperative Nursing
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  • Proteins
  • Noninfectious Respiratory Disorder
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  • Basics of Sociology
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Study Plan Lessons

Diagnostic Testing Course Introduction
Fluid & Electrolytes Course Introduction
X-Ray (Xray)
X-Ray (Xray)
X-Ray (Xray)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addisons Disease
Computed Tomography (CT)
Computed Tomography (CT)
Computed Tomography (CT)
Fluid Pressures
Informed Consent
Nursing Care and Pathophysiology for Cushings Syndrome
Fluid Shifts (Ascites) (Pleural Effusion)
Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging (MRI)
Preoperative (Preop)Assessment
Pressure Ulcers/Pressure injuries (Braden scale)
CT & MR Angiography
CT & MR Angiography
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology of Glomerulonephritis
Isotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology for Pancreatitis
Preoperative (Preop) Education
Cerebral Angiography
Cerebral Angiography
Cerebral Angiography
Hypotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Preoperative (Preop) Nursing Priorities
Thrombocytopenia
Blood Transfusions (Administration)
Cardiovascular Angiography
Cardiovascular Angiography
Cardiovascular Angiography
Fractures
Nursing Care and Pathophysiology for Hyperthyroidism
Hypertonic Solutions (IV solutions)
Integumentary (Skin) Important Points
Preload and Afterload
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Echocardiogram (Cardiac Echo)
Echocardiogram (Cardiac Echo)
Echocardiogram (Cardiac Echo)
Nursing Care and Pathophysiology for Hypothyroidism
Performing Cardiac (Heart) Monitoring
Ultrasound
Ultrasound
Interventional Radiology
Interventional Radiology
Nuclear Medicine
Cardiac Stress Test
Cardiac Stress Test
Pulmonary Function Test
Pulmonary Function Test
Endoscopy & EGD
Endoscopy & EGD
Colonoscopy
Colonoscopy
Mammogram
Biopsy
Biopsy
Electroencephalography (EEG)
Electroencephalography (EEG)
Electromyography (EMG)
Electromyography (EMG)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
General Anesthesia
Leukemia
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Diabetes Management
Dialysis & Other Renal Points
Local Anesthesia
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Moderate Sedation
Oncology Important Points
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Malignant Hyperthermia
Phosphorus-Phos
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Crohn’s Disease
Normal Sinus Rhythm
Post-Anesthesia Recovery
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Heart Failure (CHF)
Postoperative (Postop) Complications
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Sinus Tachycardia
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Discharge (DC) Teaching After Surgery
Pacemakers
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Absolute Neutrophil Count (ANC) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
Alanine Aminotransferase (ALT) Lab Values
Albumin Lab Values
Alkaline Phosphatase (ALK PHOS) Lab Values
Alpha-fetoprotein (AFP) Lab Values
Ammonia (NH3) Lab Values
Anion Gap
Antinuclear Antibody Lab Values
Base Excess & Deficit
Beta Hydroxy (BHB) Lab Values
Bicarbonate (HCO3) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Brain Natriuretic Peptide (BNP) Lab Values
C-Reactive Protein (CRP) Lab Values
Carbon Dioxide (Co2) Lab Values
Carboxyhemoglobin Lab Values
Cardiac (Heart) Enzymes
Cholesterol (Chol) Lab Values
Coagulation Studies (PT, PTT, INR)
Congestive Heart Failure (CHF) Labs
COPD (Chronic Obstructive Pulmonary Disease) Labs
Cortisol Lab Vales
Creatine Phosphokinase (CPK) Lab Values
Creatinine (Cr) Lab Values
Creatinine Clearance Lab Values
Cultures
Cyclic Citrullinated Peptide (CCP) Lab Values
D-Dimer (DDI) Lab Values
Direct Bilirubin (Conjugated) Lab Values
Dysrhythmias Labs
Erythrocyte Sedimentation Rate (ESR) Lab Values
Fibrin Degradation Products (FDP) Lab Values
Fibrinogen Lab Values
Fluid Compartments
Free T4 (Thyroxine) Lab Values
Gamma Glutamyl Transferase (GGT) Lab Values
Glomerular Filtration Rate (GFR)
Glucagon Lab Values
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Growth Hormone (GH) Lab Values
Hematocrit (Hct) Lab Values
Hemodynamics
Hemoglobin (Hbg) Lab Values
Hemoglobin A1c (HbA1C)
Hepatitis B Virus (HBV) Lab Values
Homocysteine (HCY) Lab Values
Ionized Calcium Lab Values
Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Lab Panels
Lab Values Course Introduction
Lactate Dehydrogenase (LDH) Lab Values
Lactic Acid
Lipase Lab Values
Lithium Lab Values
Liver Function Tests
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Methemoglobin (MHGB) Lab Values
Myoglobin (MB) Lab Values
Order of Lab Draws
Pediatric Bronchiolitis Labs
Phosphorus (PO4) Blood Test Lab Values
Platelets (PLT) Lab Values
Pneumonia Labs
Potassium-K (Hyperkalemia, Hypokalemia)
Prealbumin (PAB) Lab Values
Pregnancy Labs
Procalcitonin (PCT) Lab Values
Prostate Specific Antigen (PSA) Lab Values
Protein (PROT) Lab Values
Protein in Urine Lab Values
Red Blood Cell (RBC) Lab Values
Red Cell Distribution Width (RDW) Lab Values
Renal (Kidney) Failure Labs
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
ROME – ABG (Arterial Blood Gas) Interpretation
Sepsis Labs
Shorthand Lab Values
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
Total Bilirubin (T. Billi) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
Triiodothyronine (T3) Lab Values
Troponin I (cTNL) Lab Values
Urinalysis (UA)
Urine Culture and Sensitivity Lab Values
Vitamin B12 Lab Values
Vitamin D Lab Values
White Blood Cell (WBC) Lab Values