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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Concepts Covered:

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

Study Plan Lessons

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