Exam (elaborations)
NURSING NUR305 - AH1 Exam 3 Study Guide.
- Course
- Institution
NURSING NUR305 - AH1 Exam 3 Study Guide.
[Show more]
Seller
Follow
bestnurse
Reviews received
Content preview
OsteoarthritisATI: pg 461
*Definition: degenerative joint disease (DJD), a disorder characterized by progressive
deterioration of the articular cartilage. It is a noninflammatory (unless localized),
nonsystemic disease
Health promotion/prevention: joint-saving measures (good body mechanics)
- maintain healthy weight to decrease joint degeneration of hips and knees
- recommend stop smoking to reduce cartilage loss (esp. If fam hx)
- avoid or limit repetitive strain on joints (jogging, contact sports)
- recommend well-fitting shoes to prevent falls
Risk Factors:
- adults over 60
- genetic factors
- joint injury due to acute or repetitive stress on joints predisposes to later OA
- obesity (knees- weight bearing joint)
- metabolic dx (DM,SCD)
*Expected findings:
- joint pain and stiffness
- pain with join palpitations or ROM
- crepitus (grating sound caused by the rubbing of bone fragments)
- enlarged joint related to bone hypertrophy
- Heberden’s nodes enlarged at distal interphalangeal joints
- Bouchard’s nodes located at the proximal interphalangeal joints (OA is not a
symmetrical dx, but these nodes can occur bilaterally) can be inflamed and
painful
- Heberden’s and Bouchard’s cause malformation and joint hypertrophy
- inflammation resulting from secondary synovitis indiating advanced dx
- joint effusion (excess joint fluid) easily moved from one area of the joint to
another area
- vertebral radiating pain affected by cervical or lumbar compression of nerve roots
- limping gait
- back pain
Labs:
- usually normal erythrocyte sedimentation rate
- high-sensitivity C-reactive protein can be increased related to secondary
synovitis
Diagnostics:
- X-rays: show worn-down cartilage of joints
- magnetic resonance imaging with or without contrast
- CT scans
- nuclear bone scan
- CT myelogram
- EMG and nerve conduction
- arthrogram
,*Nursing Care:
- Pain Assessment/Monitoring:
- Location, characteristics, quality, severity, precipitating or relieving factors
- Sciatic nerve pain becomes worse when the leg is held straight and lifted
upward
- Musculoskeletal Assessment/Muscle Tone and Strength:
- Inspect back for vertebral alignment and tenderness
- Degree of functional limitation; ability to perform ADLS
- Gait ability and characteristics
- Proper functional/joint alignment
- Levels of fatigue and pain after activity
- ROM
- Neurological Assessment/Sensory Perception:
- Genitourinary: bowel or bladder problems
- Home Barriers
- Psychosocial Assessment:
- Pain interference with sexuality
- Depression related to pain
- Anxiety related to pain
- Alteration in self-esteem and body image due to joint deformities and
nodules
*Meds:
- Analgesic: does not provide anti-inflammatory benefits
- Monitor liver function
- *NSAIDS: relieve pain and synovitis is present
- monitor kidney and liver function (need baseline)
, - educate nephrotoxic, taken when prescribed
- educate patient to report black tarry stool, indigestion, and SOB
- Corticosteroid injections into the joints
- Opioids: tramadol is a weak opioid used for OA. Short term use only.
- Topical analgesics:
- Trolamine salicylate
- Lidocaine 5% patch: use for 12 hr daily
- Capsaicin: must wear nitrile gloves
- Therapies:
- Chiropractic/spinal manipulation
- Glucosamine supplement
- Intra-articular injections: glucocorticoids, hyaluronic acid
Total Joint Arthroplasty
- ATI: pg. 435
*Definition: replacement of all components of an articulating joint (Total joint
replacement)
Indications:
- Eliminate pain
- restore joint motions
- improve functional status & quality of life
Contraindications:
- Recent or active infection (UTI)
- Arterial impairment to the affected extremity
- Inability to follow postsurgical regimen
- Comorbid condition (uncontrolled/unstable DM, HTN)
Preprocedure education:
● Review lab diagnostics to rule out anemia, infection, or organ failure. Chest Xray
to rule out pulmonary surgery contraindications, ECG to identify any
dysrhythmias
● teach about incentive spirometry, transfusion, surgical drains, dressing, pain
control, transfer, exercises, and activity limits
● teach about autologous blood donation
● remind the client to scrub the surgical site with a prescribed antiseptic soap the
night before
● instruct client to wear clean clothes and sleep on clean linens the night before
surgery
● Take antihypertensive another meds the surgeon allows with a sip of water the
morning of surgery
*Post procedure:
- client requires extensive PT to regain mobility
- Can be d/c home or to acute rehab facility. D/C home, outpatient or in-home
therapy must be provided. 4-6 weeks
- Monitor for evidence of incisional infection (fever, increased redness, swelling,
purulent drainage)
- care for the incisional infection (clean with soap and water)
- Monitor for DVT (swelling, redness, pain in calf), Pulmonary embolism (SOB,
chest pain), and bleeding if the client is taking a anticoagulant
*Client education (post-op):
- Home care should be available for 4-6 weeks
- Monitor for infection (fever, increased redness, swelling, purulent drainage)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller bestnurse. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
80467 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now