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CARE OF SPECIFIC CONDITIONS OF THE ELDERLY: DEGENERATIVE JOINT AND BONE…
CARE OF SPECIFIC CONDITIONS OF THE ELDERLY:
DEGENERATIVE JOINT AND BONE DISORDERS
Definition
: Degenerative arthritis, also referred to osteoarthritis or degenerative joint disease (DJD), is inflammation of the joints caused by the breakdown or degeneration of cartilage in one or more joints.
Causes of Osteoarthritis
Cartilage, which provides a cushion between the bones of our joints, begins to deteriorate with degenerative arthritis. Osteoarthritis with no known cause (usually the result of aging) is referred to primary osteoarthritis, while injury, disease, obesity or trauma leading to osteoarthritis is referred to as secondary osteoarthritis.
Pathophysiology
It is expected that osteoarthritis, or the deterioration of cartilage, occurs as we age because water content in the cartilage begins to increase as we age.
• Repetitive use of worn joints irritates the cartilage.
• thereby leading to the introduction of water and swelling of the joint.
• This introduced water results in the deterioration of the cartilage.
• The cartilage, in fact, actually begins to flake and form tiny holes.
• As the decrease of cartilage between the joints progresses, osteoarthritis symptoms begin. Advanced osteoarthritis occurs when there is a complete loss of cartilage between the bones of one or more joints.
Clinical manifestations
• Most people with osteoarthritis report warmth and swelling at the affected joints, and some people actually feel as if their joints are “creaking.”
• People with degenerative arthritis also often report stiffness after periods of inactivity.
• Further, many people with osteoarthritis report that their pain is intermittent, often flaring up at times. Pain is often a problem on weight-bearing joints, such as the spine, knees and hips.
• Osteoarthritis of the small joints of the hands often causes bone spur formations around the fingers, resulting in noticeable enlargements of the ends of the fingers.
Nursing Management
• weight loss or by avoiding weight-bearing or repetitive activities that put stress on affected joints.
•Patients with moderate pain may benefit from rest, exercise, and diet control.
• Further, patients with severe pain often seek physical or occupational therapy treatments.
• They may also need supportive devices, such as walkers, splints or knee braces.
Pharmacological management
• NSAID pain relievers (Aspirin, Ibuprofen, and Naproxen)
• Topical ointments (Capsaicin, Salycin, and Menthol)
• Patches (Diclofenac)
• Injections (Hylauronic Acid)
• Surgery may be considered if other conservative measures fail to control pain.