Osteoarthritis is caused by the
biochemical breakdown of articular
cartilage in the synovial joints and
the entire joint organ, including the
subchondral bone and synovian.
Cause
Lose of balance between cartilage
breakdown and production, degeneration
exceeds regeneration
Deterioration of the articular cartilage
Increase the development
Obesity, misalignment of bones and
joints, joint trauma and injury,
exercise
Risk factors and signs/symptoms
Over the age of 45, more common in women
Pain, stiffness, swelling, harry potter wand fingers,
Treatment and Management
Pain management with NSAIDS
Non-pharm: physio,
OT, exercise,
acupuncture and
nutritional
supplements
Assessments should include
function, mood, mobility
and pain assessments
Gout
Pathophysiology
An inflammatory reaction to monosodium urate crystals.
Increased production of uric acid,
decreased excretion, increased
purine intake - increase urate
levels
Needle-shaped monosodium urate
crystals which are deposited in the
articular cartilage or in the tend
sheaths, ligaments and around
distal joints and tissues.
Risk factors and signs/symptoms
Acute and come out of nowhere.
Severe pain in the joints, nodules
on joints - redness and
inflammation, tender and hot
joints. Often onset of pain at
night.
Causes
Hyperuricemia > 6.8.
Crystals in the joints
bruv.
Treatment and Management
Pharm - rate
lowering
treatment for
recurrent
attacks
Allopurinol
Used to decrease uric acid
concentrations. Taken once daily after
meal. SIDE EFFECTS: skin reactions,
headaches.
Probenecid
Pharm - acute gout:
Colchicine
Inhibits urate crystal deposition. Not an analgesic but
relies pain in acute attacks of gout. You can't take it if
you have kidney and liver disease, cardiac or GI
disorders.
NSAIDS; diclofenac, ibuprofen
Nursing Interventions
Health education
Keep a healthy body weight, rest lots,
keep sheets off of the joint if its an
early morning attack. Drink 2L of water.
Avoid purine rich foods: red meat,
fish, yeast extracts. Avoid alcohol
and soft drinks.
Rheumatoid Arthritis
What is it
Chronic disease that cannot be cured. Form of
inflammatory arthritis and autoimmune diseases.
Fluid build up causing inflammation and joint pain,
systemic and intermittent. Is the second most
common form of arthritis and women are three
times more likely to develop RA than men.
Signs and symptoms
Fatigue, pain in the joints, swelling of the
joints, stiffness in the joints, muscle pain
Treatment and Management
Treats the symptoms. Reducing pain and inflammation,
minimising or preventing joint damage and maximising join
movement.
Interventions
Education and counselling.
Self-management support approach.
Information and referral to support
networks. Fatigue management and
exercise. Encouraing reg check ups