presentation on arthritis

arthritis,types,treatment

1. P R E S E N TAT I O N O N A R T H R I T I S

2. O B J E C T I V E S In the end of presentation learners will be able to, Define Arthritis . Discuss the common types of arthritis with signs and symptoms . Define the causes of arthritis . Explain the medical management and nursing management of arthritis. Describe Nursing diagnosis related to arthritis.

3. Arthritis means inflammation or swelling of one or more joints. it describes more than 100 conditions that affect the joints, tissues around the joint, and other connective tissues. specific symptoms vary depending on the type of arthritis, but usually include joint pain and stiffness. (C . D . C )

4. SOME COMMON TYPES ARE THERE WE DISCUSS Osteo arthritis Rheumatoid arthritis Psoriatic arthritis Gout Lupus

5. 1. OSTEO ARTHRITIS Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of your bones wears down over time. Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, knees, hips and spine.

6. In normal joints, a firm, rubbery material called cartilage covers the end of each bone. Cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between the bones. In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. As OA worsens over time, bones may break down and develop growths called spurs . Cartilage may chip off and float around in the joint. In the body, an inflammatory process occurs and cytokines (proteins) and enzymes develop that further damage the cartilage. In the final stages of OA, the cartilage wears away and bone rubs against bone leading to joint damage and more pain.

7. Who’s Affected ? Although osteoarthritis occurs in people of all ages, osteoarthritis is most common in people older than 65. Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles, and genes. One in two adults will develop symptoms of knee osteoarthritis during their lives. One in four adults will develop symptoms of hip osteoarthritis by age 85. One in 12 people 60 years or older have hand osteoarthritis

8. RHEUMATOID ARTHRITIS Rheumatoid arthritis (RA) is an autoimmune disease in which the body’s immune system – which normally protects its health by attacking foreign substances like bacteria and viruses – mistakenly attacks the joints. This creates inflammation that causes the tissue that lines the inside of joints (the synovium) to thicken, resulting in swelling and pain in and around the joints. The synovium makes a fluid that lubricates joints and helps them move smoothly.

9. W ho’s Affected by Rheumatoid Arthritis? Nearly three times as many women have the disease as men. In women, RA most commonly begins between ages 30 and 60. In men, it often occurs later in life. Having a family member with RA increases the odds of having RA; however, the majority of people with RA have no family history of the disease. Rheumatoid arthritis causes exposure to certain types of bacteria, such as those associated with periodontal disease. having a history of viral infections like infection with the Epstein-Barr virus which causes mononucleo sis. trauma or injury, such as bone breakage or fracture, dislocation of a joint, and ligament damage.

10. 3. PSORIATIC ARTHRITIS Psoriatic arthritis is a condition that combines the swollen, sore joints of arthritis with psoriasis . Psoriasis typically causes itchy, scaly red patches to appear on the skin and scalp. OR Psoriatic arthritis is a type of arthritis that develops in some people with the skin condition psoriasis . It typically causes affected joints to become inflamed (swollen), stiff and painful. Like psoriasis, psoriatic arthritis is a long-term condition that can get progressively worse. In severe cases, there's a risk of the joints becoming permanently damaged or deformed, which may require surgical treatment.

11. PSORIATIC ARTHRITIS Psoriatic arthritis occurs when your body's immune system begins to attack healthy cells and tissue. The abnormal immune response causes inflammation in your joints Physical trauma or something in the environment — such as a viral or bacterial infection — may trigger psoriatic arthritis in people with an inherited tendency.

12. GOU T Gout is a form of inflammatory arthritis that develops in some people who have high levels of uric acid in the blood. The acid can form needle-like crystals in a joint and cause sudden, severe episodes of pain, tenderness, redness, warmth and swelling.

13. SIGN & SYMPTOMS The signs and symptoms of gout almost always occur suddenly, and often at night. They include: Intense joint pain. Gout usually affects the large joint of your big toe, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists and fingers. The pain is likely to be most severe within the first four to 12 hours after it begins. Inflammation and redness. The affected joint become swollen, tender, warm and red. Limited range of motion. As gout progresses, you may not be able to move your joints normally.

14. 1 . P REVENT I O NS: DRINK PLENTY OF FLUIDS : Stay well-hydrated, including plenty of water. limit how many sweetened beverages you drink, especially those sweetened with high-fructose corn syrup . LIMIT OR AVOID ALCOHOL : Talk with your doctor about whether any amount or type of alcohol is safe for you. recent evidence suggests that beer may be particularly likely to increase the risk of gout symptoms, especially in men. GET YOUR PROTEIN FROM LOW-FAT DAIRY PRODUCTS : Low-fat dairy products may actually have a protective effect against gout, so these are your best-bet protein sources. MAINTAIN A DESIRABLE BODY WEIGHT: Choose portions that allow you to maintain a healthy weight. losing weight may decrease uric acid levels in your body. but avoid fasting or rapid weight loss, since doing so may temporarily raise uric acid levels.

15. L U P US Lupus is a systemic autoimmune disease that occurs when your body's immune system attacks your own tissues androgens. Inflammation caused by lupus. Lupus can affect many different body system __ Including your joints, skin, kidneys, blood cells, brain, heart and lungs

16. CAU S E S Lupus occurs when your immune system attacks healthy tissue in your body (autoimmune disease). It's likely that lupus results from a combination of your genetics and your environment. Sunlight . Exposure to the sun may bring on lupus skin lesions or trigger your internal response in susceptible people. Infections . Having an infection can initiate lupus or cause a relapse in some people. Medications . Lupus can be triggered by certain types of blood pressure. medications, anti- seizure medications and antibiotics. People who have drug induced lupus usually get better when they stop taking the medication. Rarely, symptoms may persist even after the drug is stopped.

17. ANALGESICS GENERAL PAIN KILLERS (ANALGESICS) ease mild to moderate pain but don’t do anything for inflammation (hot, swollen joints). ACETAMINOPHEN (TYLENOL) is available over the counter and is often used for arthritis because it doesn’t hurt your heart and stomach the way nonsteroidal anti-inflammatory agents (nsaids) can. but too much can harm your liver.

18. NONSTEROIDALANTI-INFLAMMATORY DRUGS (NSAIDS) N S A I D S r e li e v e p a i n a n d i n f l a mm a ti o n b y b l o c k i n g h o r m o n e - li k e s u b s t a n ce s called prostaglandins. NAPROXEN (ALEVE) , ASPIRIN AND IBUPROFEN (MOTRIN, ADVIL) are available over the counter. others INDOMETHACIN (INDOCIN) AND CELECOXIB (CELEBREX) require a prescription. {NSAIDS CAN INCREASE YOUR CHANCES OF HAVING A HEART ATTACK, STROKE OR A STOMACH BLEED.}

19. CORTICOSTEROIDS Sometimes called steroids or glucocorticoids, reduce inflammation by acting like your natural hormone cortisol. they work quickly so are good for short-term relief. But they can create problems like weight gain, cataracts and high blood pressure. if you need to take them for a long time, your doctor will have you take only a small amount each day.

20. OPIOIDS Are pain killers that must be prescribed by a doctor. they are very strong and can work well for severe pain. but they do have more side effects than acetaminophen and people can become dependent on them or addicted. Donald Miller, pharm D, professor, department of pharmacy practice at north Dakota state university in Fargo warns they are not much more useful for long-term use than acetaminophen or nsaids.

21. NURSING DIAGNOSIS FOR PATIENTS WITH ARTHRITIS :- ACUTE PAIN /CHRONIC PAIN :- IMPAIRED PHYSICAL MOBILITY :- ACTIVITY INTOLERANCE :- RISK OR INJURY RELATED TO : . BONE DEFORMITIES . MUSCLES SPASM . JOINT DEGENERATION . PHYSICAL MOBILITY

22. POSSIBLY EVIDENCED BY CRYING FACIAL GRIMACES IRRITABILITY PROTECTIVE, GUARDED BEHAVIOR RESTLESSNESS R EP O R T S O F P A I N , S P A S M, T I N G L I N G , NU M B N E S S WITHDRAWAL

23. NURSING INTERVENTION ASSESS THE CLIENT’S DESCRIPTION OF PAIN. The client may report pain in the fingers , hips , knees , lower lumbar spine , and cervical vertebrae . Pain is usually provoked by activity and relieved by rest; joint pain and aching may also be present when the client is at rest. Pain may manifest as an ache, progressing to sharp pain when the affected area is brought to full weight-bearing or a full range of motion (rom). the client may experience sharp , painful muscle spasms.

24. DETERMINE WHETHER THE CLIENT IS REPORTING ALL OF THE PAIN HE OR SHE IS EXPERIENCING. Clients who have become accustomed to living with chronic pain may learn to tolerate basal levels of discomfort and only reports those discomforts that exceed these “normal” levels. The care provider is not getting an accurate picture of the client’s status if this pain is not reported. The nurse may need to be sensitive to nonverbal cues that pain is present .

25. APPLY A HOT OR COLD PACK. HEAT REDUCES PAIN THROUGH IMPROVED BLOOD FLOW TO THE AREA AND THROUGH THE REDUCTION OF PAIN REFLEXES. SPECIAL ATTENTION NEEDS TO BE GIVEN TO PREVENTING BURNS WITH THIS INTERVENTION. COLD REDUCES PAIN, INFLAMMATION, AND MUSCLE SPASTICITY BY DECREASING THE RELEASE OF PAIN-INDUCING CHEMICALS AND SLOWING THE CONDUCTION OF PAIN IMPULSES. THESE INTERVENTIONS REQUIRE NO SPECIAL EQUIPMENT AND CAN BE COST-EFFECTIVE. HOT OR COLD APPLICATIONS SHOULD LAST ABOUT 20 TO 30 MIN/HR.

26. MEDICATE FOR PAIN BEFORE ACTIVITYAND EXERCISE THERAPY. EXERCISE IS NECESSARY TO MAINTAIN JOINT MOBILITY, BUT CLIENTS MAY BE RELUCTANT TO PARTICIPATE IN EXERCISE IF THEY ARE IN TOO MUCH PAIN.

27. REFERENCES : Arthritis foundation ( www.arthritis.org ) www.VersusArthritis.com www.nhu.uk/condition/psoriaticarthritis . The Centers for Disease Control and Prevention (CDC) https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms- causes/syc-20350772 https:// www.medicinenet.com/ar thritis/article.htm