Osteoarthritis kmu for nursing stidents .pptx

presentation on oteoarthritis

1. OSTEOARTHRITIS Lecturer Sir Awal Sher INS-KMU

2. objectives By the end of this presentation student will be able to: Define osteoarthritis Classification of osteoarthritis Describe the pathophysiology of osteoarthritis Recognize the risk factor of osteoarthritis Identify causes of osteoarthritis Enlist signs and symptoms of osteoarthritis Explain medical and surgical management of osteoarthritis Identify nursing management and intervention

3. Definition; Osteoarthritis is the most common kind of arthritis associated with progressive degeneration of articular cartilage in the joint.  Some people call it degenerative joint disease or “wear and tear” arthritis. It occurs most frequently in the hands, hips, and knees .

4. Classification of AO Osteoarthritis is classified into two classifications Primary or idiopathic OA  The cause of primary OA is unknown. However, it is associated with aging and tends to develop around age 55 to 60.  Secondary OA  results from previous joint injury or inflammatory disease.

5. Pathophysiology Due to degeneration of articular cartilage and calcification of ligament. Weight bearing joints become immobile begins with erosion of the joint cartilage causing fissures/ cracking loss of cartilage bone contact Joint immobility and bone destruction /remodeling Peritonsillar abscess (puss formation)

6. Obesity Joint injury or trauma Joint overuse (occupational or recreational) Abnormal alignment of the legs A family history of osteoarthritis

7. Causes of OA: Age factors Gender Genetic and hormones Obesity Occupational or physical activates /sports injury

8. Clinical Features Pain.  Affected joints might hurt during or after movement. Stiffness.   Tenderness .   joint might feel tender when you apply light pressure to or near it. Loss of flexibility . Grating sensation.   Bone spurs.  These extra bits of bone, which feel like hard lumps, can form around the affected joint . Swelling.  This might be caused by soft tissue inflammation around the joint .

9. Investigations Physical assessment of the musculoskeletal system reveals the  tender and swollen joints . X-rays cartilage doesn’t show up on x-ray image, but cartilage loss is revealed by a narrowing of the space between the bone in your joint . X-ray.  OA is characterized by a progressive loss of joint cartilage, which appears on x-ray as a  narrowing of the joint space .

10. Cont... MRI gives a better view of cartilage and other parts of the joint . Joint fluid analysis; . Your doctor might use a needle to draw fluid from an affected joint. The fluid is then tested for inflammation and to determine whether your pain is caused by Gout or an infection rather then AO.

11. Medical management of AO Management focuses on slowing and treating symptoms because there is no treatment available that stops the degenerative joint disease process. The main treatments for the symptoms of osteoarthritis include: lifestyle measures – such as maintaining a healthy weight and exercising regularly Weight reduction is strongly recommended Pharmacologic therapy.  Initial analgesic therapy is  acetaminophen , while some are responsive to NSAIDs and opioids. Joint rest.  The patient should avoid joint overuse and rest the joints regularly.

12. Cont.….. Supportive treatments Hot or cold packs Applying hot or cold packs to the joints can relieve the pain and symptoms of osteoarthritis in some people.

13. Cont … Nutritional supplements vitamin D supplements. Vitamin C Diet : vegetables, fruits, grains Manual therapy physiotherapy Manual therapy is a technique where a physiotherapist uses their hands to stretch, mobilize and massage the body tissues to keep your joints supple and flexible.

14. Surgical management:   Joint replacement Joint replacement, also known as an arthroplasty, is most commonly done to replace hip and knee joints . Arthrotomy ;surgical opening of joint Arthrodesis (joint fusion)

15. Nursing Interventions The major goals of the nursing intervention are pain management and optimal functional ability. Weight loss.  Weight loss is an important approach to pain and disability improvement. Assistive devices.  Canes and other ambulatory devices are very helpful for ambulation. Exercise.  Exercises such as walking should begin moderately and increase gradually. Analgesic.  Adequate pain management is essential to the success of an exercise program. Physical therapy.  A referral for physical therapy for people with similar problems can be very helpful.

16. Nursing Care Plans Nursing diagnosis and intervention Nursing care plan for clients with osteoarthritis involves relieving  pain promoting comfort measures, maintaining optimal joint function, and preventing progressive disability. Nursing diagnosis for patients with osteoarthritis: Acute Pain/Chronic Pain Impaired Physical Mobility Activity Intolerance Risk For Injury

17. Pain acute/chronic Acute Pain Chronic Pain Assess the client’s description of pain . Assess the client’s previous experiences with pain and pain relief. Apply a hot or cold pack. Change positions frequently. Medicate for pain before activity and exercise therapy. Provide for adequate rest. Support joints in a slightly flexed position through the use of pillows, rolls, and towels. Instruct the client to take prescribed analgesics and/or anti-inflammatory medications e.g Acetaminophen NSAIDs ophoids

18. 2.. Impaired Physical Mobility May be related to Fatigue Muscle weakness Pain Restricted joint movement Stiffness. Assess the client’s posture and gait. Assess the client’s weight. Excessive weight may add stress to painful joints. Assess the client’s ability to perform ADLs. Assess the client’s comfort with and knowledge of how to use assistive devices. Provide the client with access to and support during weight-reduction programs Weight reduction results in decreased trauma to bones, muscles, and joints Consult physical therapy staff to prescribe an exercise program

19. 3..Activity Intolerance Activity Intolerance m ay be related to d ecrease muscle tone Joint pain Assess the physical activity level and mobility of the client Assess the client’s nutritional status . Adequate energy reserves are needed during activity. Assess the need for ambulation aids (e.g., cane, walker) Exercise maintains muscle strength, joint ROM, and exercise tolerance.

20. 4 ..Risk For Injury Risk for Injury May be related to Altered mobility Decreased bone function Pain/discomfort Assist client with active and passive ROM exercises and as tolerated . Maintains and enhances muscle strength, joint function. Encourage client to lose weight to decrease stress on weight-bearing joints Excess weight adds extra stress on the joints. Instruct the client to use the softest surface available during exercise. Instruct the use of adaptive mobility equipment such as walkers, canes, and crutches as indicated .

21. Cont.… Instruct the client regarding safety measures Raised chairs and toilet seat Use of handrails Accurate use of mobility equipment and wheelchair safety . Helps prevent accidental injuries and falls

22. Evaluation Identified negative factors affecting activity intolerance and eliminate or reduce their effects when possible. Used identified techniques to enhance activity intolerance. Reported measurable increase in activity intolerance. Reported pain is relieved or controlled. Followed prescribed pharmacologic regimen. Participated in ADLs and desired activities.

23. ANY QUESTION?