ARTHRITIS
DEFINITION
Arthritis is an inflammation of joints.
ETIOLOGY
Haematogenous spread.
Directly through trauma or surgical instrumentation.
Previous trauma to joints.
Joint replacement.
Coexisting arthritis.
Weak immune system.
Most commonly, it is caused by S. aureus.
TYPES OF ARTHRITIS
The three common types are osteoarthritis,
rheumatoid arthritis and gout.
1. Osteoarthritis:
A condition in which the cartilage that protects and
cushions joints breaks down resulting in damage to
the tissue and underlying bone and causing painful
joint symptoms.
2. Rheumatoid Arthritis (RA): An
inflammation of the membranes or
tissues lining the joints, which may
destroy the joint tissues, including
cartilage, ligaments, tendons and bone.
3.Gouty Arthritis (gout): An
inflammatory joint disease; usually the
chemistry with a painful build-up of
uric acid crystals in the knees and big
toes.
PATHOPHYSIOLOGY
Inflammation of synovium
Antigen and inflammatory by- products formation
Destruction of articular cartilage
Edema and pannus formation
Formation of adhesions
Decreased joint mobility
CLINICAL MANIFESTATIONS
Warm, painful, swollen joint
Decreased range of motion
Chills, fever and leukocytosis
DIAGNOSTIC EVALUATION
Synovial fluid culture and examination
Computed tomography
Aspiration
Radio-isotope scanning
MRI
Radio-isotope scanning
MANAGEMENT
1. To control infection: I/V Broad-spectrum
antibiotics according to the culture results such as
ampicillin, gentamycin are used.
2. Monitoring of synovial fluid: The physician
may aspirate the joint with a needle to remove
excessive joint fluid, exudates. Synovial fluid is
monitored for sterility and decrease in WBCs.
3. Immobilization affected: Inflamed joint is
supported and immobilized by a splint that provides
comfort to the patient.
4. To prevent recurrence: Assessment of the
patient periodically is necessary to check its
recurrence.
5. Arthrotomy or arthroscopy is used to drain the
joint and remove dead tissue.
6. The inflamed joint is supported and
immobilized in a functional position by a splint
that increases the patient’s comfort.
7. Analgesics may be prescribed to control
pain.
8. After the infection has responded to
antibiotic therapy, NSAIDS may be
prescribed to limit joint damage.
NURSING MANAGEMENT
1. Assess the physical signs and symptoms; assess
the patient for psychosocial, functional and
vocational needs.
2. Assess the patient’s nutritional and fluid status.
3. Once the infection subsides, encourage for
progressive range of motion exercises.
4. Explain client about disease and its treatment.
5. Provide hot shower which helps to decrease joint
stiffness and make exercise easier for the patient.
6. Provide rest and exercise later in the day is
most beneficial for the patient.
7. Teach him the measures to relieve pain using
pharmacologic and non pharmacologic
interventions.
8. Provide physical therapy, occupational and
social worker.
9. Complementary therapy that may help to
decrease inflammation or pain include
capsaicin cream, fish oil, magnetic therapy and
antioxidants such as vitamin C, vitamin E.
10. Teach the ways of controlling pain.
11. Medications are adjusted to control pain as
well as to decrease the inflammation
process.
HEALTH EDUCATION
Explain him about the importance of
supporting the affected joint.
Avoid weight-bearing and also restrict
activity.
Encourages the patient to practice safe use
of ambulatory aids and assistive devices.
Encourage client to perform range of
motion exercises after the infection
subsides.
Arthritis.pptx