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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Study Plan for Study Skills, Test Taking for the NCLEX® Using Med-Surg (Lewis 10th ed.) designed for Westmoreland County Community College

Concepts Covered:

  • Concepts of Population Health
  • Factors Influencing Community Health
  • Community Health Overview
  • Substance Abuse Disorders
  • Upper GI Disorders
  • Renal Disorders
  • Newborn Care
  • Integumentary Disorders
  • Tissues and Glands
  • Central Nervous System Disorders – Brain
  • Digestive System
  • Urinary Disorders
  • Urinary System
  • Musculoskeletal Trauma
  • Concepts of Mental Health
  • Health & Stress
  • Developmental Theories
  • Fundamentals of Emergency Nursing
  • Communication
  • Basics of NCLEX
  • Test Taking Strategies
  • Prioritization
  • Delegation
  • Emotions and Motivation
  • Integumentary Disorders
  • Legal and Ethical Issues
  • Basic
  • Preoperative Nursing
  • Labor and Delivery
  • Fetal Development
  • Newborn Complications
  • Postpartum Complications
  • Postpartum Care
  • Labor Complications
  • Pregnancy Risks
  • Prenatal Concepts
  • Circulatory System
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Vascular Disorders
  • Shock
  • Postoperative Nursing
  • Intraoperative Nursing
  • Oncology Disorders
  • Neurological Emergencies
  • Respiratory Disorders
  • Female Reproductive Disorders
  • Acute & Chronic Renal Disorders
  • Liver & Gallbladder Disorders
  • Lower GI Disorders
  • Disorders of Pancreas
  • Disorders of the Thyroid & Parathyroid Glands
  • Disorders of the Adrenal Gland
  • Disorders of the Posterior Pituitary Gland
  • Immunological Disorders
  • Hematologic Disorders
  • EENT Disorders
  • Integumentary Important Points
  • Musculoskeletal Disorders
  • Emergency Care of the Neurological Patient
  • Peripheral Nervous System Disorders
  • Central Nervous System Disorders – Spinal Cord
  • Neurologic and Cognitive Disorders
  • Eating Disorders
  • Noninfectious Respiratory Disorder
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Psychological Emergencies
  • Trauma-Stress Disorders
  • Personality Disorders
  • Cognitive Disorders
  • Bipolar Disorders
  • Depressive Disorders
  • Psychotic Disorders
  • Anxiety Disorders
  • Somatoform Disorders
  • Infectious Disease Disorders
  • Musculoskeletal Disorders
  • Renal and Urinary Disorders
  • Cardiovascular Disorders
  • EENT Disorders
  • Gastrointestinal Disorders
  • Hematologic Disorders
  • Oncologic Disorders
  • Endocrine and Metabolic Disorders
  • Childhood Growth and Development
  • Adulthood Growth and Development
  • Medication Administration
  • Nervous System
  • Dosage Calculations
  • Learning Pharmacology
  • Prefixes
  • Suffixes

Study Plan Lessons

Communicable Diseases
Disasters & Bioterrorism
Cultural Care
Environmental Health
Technology & Informatics
Epidemiology
Health Promotion & Disease Prevention
Head to Toe Nursing Assessment (Physical Exam)
Enteral & Parenteral Nutrition (Diet, TPN)
Specialty Diets (Nutrition)
Blood Glucose Monitoring
Intake and Output (I&O)
Hygiene
Pain and Nonpharmacological Comfort Measures
Bowel Elimination
Urinary Elimination
Complications of Immobility
Patient Positioning
Defense Mechanisms
Overview of Developmental Theories
Abuse
Therapeutic Communication
Overview of the Nursing Process
Triage
Prioritization
Delegation
Maslow’s Hierarchy of Needs in Nursing
Isolation Precaution Types (PPE)
Fall and Injury Prevention
Fire and Electrical Safety
Brief CPR (Cardiopulmonary Resuscitation) Overview
HIPAA
Advance Directives
Legal Considerations
Process of Labor
Fetal Circulation
Fetal Environment
Newborn of HIV+ Mother
Hyperbilirubinemia (Jaundice)
Transient Tachypnea of Newborn
Meconium Aspiration
Babies by Term
Newborn Reflexes
Body System Assessments
Newborn Physical Exam
Postpartum Hemorrhage (PPH)
Mastitis
Initial Care of the Newborn (APGAR)
Breastfeeding
Postpartum Discomforts
Postpartum Physiological Maternal Changes
Dystocia
Precipitous Labor
Preterm Labor
Abruptio Placentae (Placental abruption)
Placenta Previa
Prolapsed Umbilical Cord
Fetal Heart Monitoring (FHM)
Leopold Maneuvers
Mechanisms of Labor
Fetal Development
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Gestational HTN (Hypertension)
Hydatidiform Mole (Molar pregnancy)
Ectopic Pregnancy
Disseminated Intravascular Coagulation (DIC)
Gestational Diabetes (GDM)
Nutrition in Pregnancy
Chorioamnionitis
Antepartum Testing
Discomforts of Pregnancy
Physiological Changes
Maternal Risk Factors
Fundal Height Assessment for Nurses
Gravidity and Parity (G&Ps, GTPAL)
Gestation & Nägele’s Rule: Estimating Due Dates
Family Planning & Contraception
Menstrual Cycle
Hemodynamics
Normal Sinus Rhythm
Performing Cardiac (Heart) Monitoring
Preload and Afterload
Sinus Bradycardia
Sinus Tachycardia
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Angina
Pacemakers
Nursing Care and Pathophysiology of Hypertension (HTN)
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
Discharge (DC) Teaching After Surgery
Postoperative (Postop) Complications
Post-Anesthesia Recovery
Malignant Hyperthermia
Moderate Sedation
Local Anesthesia
Preoperative (Preop)Assessment
General Anesthesia
Preoperative (Preop) Nursing Priorities
Preoperative (Preop) Education
Informed Consent
Biopsy
Ultrasound
Echocardiogram (Cardiac Echo)
Cardiovascular Angiography
Cerebral Angiography
Magnetic Resonance Imaging (MRI)
X-Ray (Xray)
Computed Tomography (CT)
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Dialysis & Other Renal Points
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Nursing Care and Pathophysiology for Pancreatitis
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Diabetes Management
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Addisons Disease
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Oncology Important Points
Lymphoma
Leukemia
Blood Transfusions (Administration)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Glaucoma
Macular Degeneration
Hearing Loss
Fractures
Cataracts
Integumentary (Skin) Important Points
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Burn Injuries
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Seizure
Seizure Therapeutic Management
Seizure Assessment
Seizure Causes (Epilepsy, Generalized)
Stroke Nursing Care (CVA)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Therapeutic Management (CVA)
Stroke Assessment (CVA)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Miscellaneous Nerve Disorders
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Cerebral Perfusion Pressure CPP
Intracranial Pressure ICP
Adjunct Neuro Assessments
Levels of Consciousness (LOC)
Routine Neuro Assessments
Hemoglobin A1c (HbA1C)
Glucose Lab Values
Urinalysis (UA)
Creatinine (Cr) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Ammonia (NH3) Lab Values
Cholesterol (Chol) Lab Values
Albumin Lab Values
Coagulation Studies (PT, PTT, INR)
Platelets (PLT) Lab Values
White Blood Cell (WBC) Lab Values
Hematocrit (Hct) Lab Values
Red Blood Cell (RBC) Lab Values
Hemoglobin (Hbg) Lab Values
Chloride-Cl (Hyperchloremia, Hypochloremia)
Sodium-Na (Hypernatremia, Hyponatremia)
Potassium-K (Hyperkalemia, Hypokalemia)
Hypertonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Isotonic Solutions (IV solutions)
Base Excess & Deficit
Metabolic Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Respiratory Alkalosis
Respiratory Acidosis (interpretation and nursing interventions)
ABG (Arterial Blood Gas) Interpretation-The Basics
ABGs Nursing Normal Lab Values
Chest Tube Management
Nursing Care and Pathophysiology of Pneumonia
Artificial Airways
Airway Suctioning
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Lung Sounds
Alveoli & Atelectasis
Gas Exchange
Nursing Care and Pathophysiology for Asthma
Suicidal Behavior
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Mood Disorders (Bipolar)
Depression
Schizophrenia
Generalized Anxiety Disorder
Post-Traumatic Stress Disorder (PTSD)
Somatoform
Dissociative Disorders
Anxiety
Pertussis – Whooping Cough
Varicella – Chickenpox
Mumps
Rubeola – Measles
Scoliosis
Attention Deficit Hyperactivity Disorder (ADHD)
Autism Spectrum Disorders
Spina Bifida – Neural Tube Defect (NTD)
Meningitis
Enuresis
Nephrotic Syndrome
Cerebral Palsy (CP)
Mixed (Cardiac) Heart Defects
Obstructive Heart (Cardiac) Defects
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Congenital Heart Defects (CHD)
Cystic Fibrosis (CF)
Asthma
Acute Otitis Media (AOM)
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Tonsillitis
Conjunctivitis
Constipation and Encopresis (Incontinence)
Intussusception
Appendicitis
Celiac Disease
Pediatric Gastrointestinal Dysfunction – Diarrhea
Vomiting
Hemophilia
Nephroblastoma
Fever
Dehydration
Sickle Cell Anemia
Burn Injuries
Pediculosis Capitis
Impetigo
Eczema
Growth & Development – School Age- Adolescent
Growth & Development – Preschoolers
Growth & Development – Toddlers
Growth & Development – Infants
Care of the Pediatric Patient
Vitals (VS) and Assessment
Vasopressin
TCAs
SSRIs
Proton Pump Inhibitors
Vancomycin (Vancocin) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Metronidazole (Flagyl) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Parasympatholytics (Anticholinergics) Nursing Considerations
NSAIDs
Nitro Compounds
MAOIs
Hydralazine (Apresoline) Nursing Considerations
Insulin
Magnesium Sulfate
HMG-CoA Reductase Inhibitors (Statins)
Histamine 2 Receptor Blockers
Histamine 1 Receptor Blockers
Epoetin Alfa
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Corticosteroids
Benzodiazepines
Cardiac Glycosides
Calcium Channel Blockers
Parasympathomimetics (Cholinergics) Nursing Considerations
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Autonomic Nervous System (ANS)
Atypical Antipsychotics
Angiotensin Receptor Blockers
ACE (angiotensin-converting enzyme) Inhibitors
Renin Angiotensin Aldosterone System
Complex Calculations (Dosage Calculations/Med Math)
IV Infusions (Solutions)
Injectable Medications
Oral Medications
Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
The SOCK Method – K
The SOCK Method – C
The SOCK Method – O
The SOCK Method – S
The SOCK Method – Overview
6 Rights of Medication Administration
Essential NCLEX Meds by Class
12 Points to Answering Pharmacology Questions
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
54 Common Medication Prefixes and Suffixes