Degenerative joint disorders (Joints)
Definition
IT is known as "wear-and-tear" it develops as joint wears down allowing bones to rub against each other.
Arthritis
Definition
The term is generally used to denote pain and inflammation of the joint, there are many types of arthritis which are primarily classified as inflammatory and non inflammatory. Rheumatoid arthritis is related to autoimmune reaction and therefore inflammatory in nature.
Osteoarthritis
References
Definition
Is a chronic non-inflammatory degenerative joint diseases in which there is progressive loss of articular cartilage and capsular fibrosis. Mostly often affects weight-bearing joints like knees, hip, vertebrae column. Smaller joints that are usually affected are those of the fingers it is common in people from 40 to 60 years above.
Risk factors
Advancing age
Previous joint injury or surgery
Genetic predisposition
Congenital anatomical abnormality of the joint.
Pathophysiology
In osteoarthritis there is deterioration of articular cartilage and a decrease in the synovium that lubricates the joints.
Friction increases resulting in pain stiffness of the joint and compromised mobility
With age, as the supporting structures around joints become lax, the stability of joints is also affected, joints slip and there is uneven wearing off of cartilage adges.
Causes
There may be an observable deformity
There may be a history of an injury or surgery in the affected joint
There may be wear and tear in the articular cartilage experience with age.
Clinical manifestation
Stiffness and pain with limitation of mobility mostly experience in the morning upon waking.
Crunching sound in the affected joint
May present with deformities and nodules.
Nursing management
The patient should also be encouraged to join support group
Referral to other health professionals such as the physiotherapist, operational therapist and social
Patient education regarding weight reduction accepting the disease and incorporating it into near lifestyle, achieving a balance between rest and activity.
Pain management which include immobilization of the joint.
Application of moist heat or cold to relieve pain diversional therapy, and isometric and isotonic exercises to strengthen the muscle of the affected joints to relieve pain and prevent further injuries.
Rheumatoid arthritis
Definition
Is an autoimmune disease that causes symmetrical inflammation of the joint. Starting with the synovial membrane, then the articular surfaces and other structures of the joint resulting in pain and deformity
Symptoms
Joint pain
Warmth over the joint
Swelling
Decreased ROM and multiple joint stiffness especially in the morning
Low-grade fever and weight loss
Nursing management
Therapy of pain relief
Minimising joint destruction and promoting joint function
Braces, splints or other assistive devices may be used to limit joint-use especially during the bouts or severe inflammation.
Other interventions are similar to those mentioned in osteoarthritis
Gout
Definition
Is a form of arthritis associated with hyperuricemia whereby a uric acid crystals precipitate from the body and are deposited in the joints and connective tissue.
Causes
Genetic error in purine metabolism or following excessive consumption of a high purine diet and alcohol
Associated with rich people who have unlimited access to protein-rich foods and alcohol
Mostly common in men than women
Onset is usually between the ages of 40 and 60
Gout is due to a variety of conditions leading to hyperuricemia
Pathophysiology
Uric acid the end product in purine metabolism is excreted by the kidneys hyperuricemia maybe due to an increased urine formation or decreased renal excretion.
Clinical manifestation
Inflammation and swelling of the affected joint
Any joint can be affected by the beauty is their most common
Painful attacks usually starts at night and can last for up to seven days
Nursing management
Resting the affected joint
Elevating the limp and removing the weight of bedclothes
Cold compresses can be applied to relieve pain
Giving non-steroidal anti-inflammatory drugs such as aspirin or colchicine.
Teach about weight control if the patient is overweight
Patient should limit or restrict high purine foods from their diet such as organ meat, poultry, fish, mushrooms and limit alcohol
Joyce Mokoena, Motshedisi Chauke, Mogkgadi Matlakala (2018) Juta's Complete Textbook of Medical Surgical Nursing Second Edition Published Juta and Company (Pty) Ltd Cape Town South Africa