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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  • Test Taking Strategies
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  • Disorders of the Adrenal Gland
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Study Plan Lessons

12 Points to Answering Pharmacology Questions
Glaucoma
Glaucoma
54 Common Medication Prefixes and Suffixes
Addisons Disease
Burn Injuries
Burn Injuries
Cataracts
Cataracts
Nursing Care and Pathophysiology for Cushings Syndrome
Macular Degeneration
Macular Degeneration
Pressure Ulcers/Pressure injuries (Braden scale)
Pressure Ulcers/Pressure injuries (Braden scale)
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Essential NCLEX Meds by Class
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
6 Rights of Medication Administration
Hearing Loss
Hearing Loss
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology of Osteoporosis
Thrombocytopenia
Blood Transfusions (Administration)
Fractures
Fractures
Nursing Care and Pathophysiology for Hyperthyroidism
Integumentary (Skin) Important Points
Integumentary (Skin) Important Points
Nursing Care and Pathophysiology for Hypothyroidism
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Anxiety
Basics of Calculations
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Generalized Anxiety Disorder
Leukemia
Diabetes Management
Lymphoma
Oral Medications
Post-Traumatic Stress Disorder (PTSD)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Injectable Medications
Oncology Important Points
Somatoform
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
IV Infusions (Solutions)
Complex Calculations (Dosage Calculations/Med Math)
Mood Disorders (Bipolar)
Depression
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Suicidal Behavior
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Benzodiazepines
MAOIs
SSRIs
TCAs
Insulin
Histamine 1 Receptor Blockers
Histamine 2 Receptor Blockers
Renin Angiotensin Aldosterone System
ACE (angiotensin-converting enzyme) Inhibitors
Angiotensin Receptor Blockers
Calcium Channel Blockers
Cardiac Glycosides
Metronidazole (Flagyl) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Atypical Antipsychotics
Autonomic Nervous System (ANS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Parasympathomimetics (Cholinergics) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Epoetin Alfa
HMG-CoA Reductase Inhibitors (Statins)
Magnesium Sulfate
NSAIDs
Corticosteroids
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Vasopressin
Dissociative Disorders
Proton Pump Inhibitors
Schizophrenia
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)