Osteoarthritis

Osteoarthritis

Ø Chronic non-systemic disorder of joints characterized by degeneration of articular cartilage

Ø Weight-bearing joints (spine, knees and hips) & terminal interphalangeal joints of fingers most commonly affected

Incident Rate

1.   Women & men affected equally

2.   Incidence increases with age

Risk factors

®   Increased age

®  Obesity

®  Repetitive use of joints with previous joint damage

® Anatomical deformity

®genetic susceptibility

S/sx

1.   Pain: (aggravated by use & relieved by rest) & stiffness of joints

2.   Heberden’s nodes: bony overgrowths at terminal interphalangeal joints

3.   Decreased ROM with possible crepitation (grating sound when moving joints)

Dx

1.   X-rays: show joint deformity as disease progresses

2.   ESR: may be slightly elevated when disease is inflammatory

Nursing Interventions

1.   Assess joints for pain & ROM.

2.   Relieve strain & prevent further trauma to joints.

a.   Encourage rest periods throughout day.

b.   Use cane or walker when indicated.

c.   Ensure proper posture & body mechanics.

d.   Promote weight reduction: if obese

e.   Avoid excessive weight-bearing activities & continuous standing.

3.   Maintain joint mobility and muscle strength.

a.   Provide ROM & isometric exercises.

b.   Ensure proper body alignment.

c.   Change client’s position frequently.

4.   Promote comfort / relief of pain.

a.   Administer medications as ordered:

§  Aspirin & NSAID: most commonly used

§  Corticosteroids (Intra-articular injections): to relieve pain & improve mobility.

b.   Apply heat or ice as ordered (e.g. warm baths, compresses, hot packs): to reduce pain.

5.   Prepare client for joint replacement surgery if necessary.

6.   Provide client teaching and discharge planning concerning

a.   Used of prescribed medications and side effects

b.   Importance of rest periods

c.   Measures to relieve strain on joints

d.   ROM and isometric exercises

e.   Maintenance of a well-balanced diet

f.    Use of heat/ice as ordered