MUSCULOSKELETAL PROBLEMS ARTHRITIS AND CONNECTIVE TISSUE DISEASES Part

MUSCULOSKELETAL PROBLEMS & ARTHRITIS AND CONNECTIVE TISSUE DISEASES Part 2 Updated 2014

OSTEOMYELITIS • Etiology/Pathophysiology • Clinical Manifestations • Diagnostic Studies • Collaborative Care

NURSING MANAGEMENT: OSTEOMYELITIS • Nursing Assessment • Nursing Diagnoses • Planning • Nursing Implementation § § § Health promotion Acute intervention Ambulatory and home care • Evaluation

METASTATIC BONE CANCER • Common sites for primary tumor are breast, prostate, lungs, kidney, & thyroid • Metastatic bone lesions commonly found in vertebrae, pelvis, femur, humerus, or ribs

NURSING MANAGEMENT: BONE CANCER • Nursing Assessment • Nursing Diagnoses • Planning • Nursing Implementation § § § Health promotion Acute intervention Ambulatory and home care • Evaluation

INTERVERTEBRAL DISK DISEASE • Etiology/Pathophysiology • Clinical Manifestations • Diagnostic Studies • Collaborative Care § Surgical therapy

INTERVERTEBRAL DISK DISEASE Fig. 64 -5. Common causes of degenerative disk damage.

NURSING MANAGEMENT: SPINAL SURGERY • Review page 1630 for different types of spinal surgeries • Post-operative Care § § Proper spinal alignment Pain management Monitor for complications Activity level

OSTEOPOROSIS • Etiology/Pathophysiology • Clinical Manifestations • Diagnostic Studies

NURSING AND COLLABORATIVE MANAGEMENT: OSTEOPOROSIS • Collaborative Care • Drug Therapy § § § Calcitonin Biphosphonates Selective estrogen receptor modulators

ARE YOU READY? A postmenopausal woman who has a BMI of 18 is at the clinic for her annual wellwoman’s examination. Which teaching plan topic should the nurse prepare for this high-risk client? 1. 2. 3. 4. Obesity Anorexia Osteoporosis Breast Cancer

ARE YOU REALLY READY? Alendronate (Fosamax) is prescribed for a client with osteoporosis. The nurse instructs the client to: 1. Take the medication at bedtime. 2. Take the medication with breakfast. 3. Lie down for 30 minutes after taking the medication. 4. Take the medication with a full glass of water after rising in the morning.

OSTEOARTHRITIS • Etiology/Pathophysiology • Clinical Manifestations § § § Systemic Joints Deformity • Diagnostic Studies

OSTEOARTHRITIS • Collaborative Care Rest and joint protection Heat and cold applications Nutritional therapy and exercise Complementary and alternative therapies § Drug therapy § §

NURSING MANAGEMENT: OSTEOARTHRITIS • Nursing Assessment • Nursing Diagnoses • Planning • Implementation • Evaluation

RHEUMATOID ARTHRITIS • Etiology and Pathophysiology • Clinical Manifestations § § Joints Extraarticular manifestations

RHEUMATOID ARTHRITIS • Diagnostic Studies • Collaborative Care § § Drug therapy Nutritional therapy

NURSING MANAGEMENT: RHEUMATOID ARTHRITIS • Nursing Assessment • Nursing Diagnoses • Planning

NURSING MANAGEMENT: RHEUMATOID ARTHRITIS • Nursing Implementation § § § Health promotion Acute intervention Ambulatory and home care Rest • Joint protection • Heat and cold therapy and exercise • Psychologic support • Weight management • • Evaluation

ARE YOU READY? The client has been on treatment for RA for 3 weeks. During the administration of etanercept (Enbrel), it is most important to assess: 1. The injection site for itching & edema 2. The WBC and platelet counts 3. If the client is having joint pain 4. A metallic taste in the mouth

GOUT • Etiology and Pathophysiology • Clinical Manifestations and Complications • Diagnostic Studies • Collaborative Care § § Drug therapy Nutritional therapy

ARE YOU READY? Colchicine is prescribed for a client with gout. The nurse knows this medication would be used with caution in which of the following disorders? 1. Myxedema 2. Renal failure 3. Hypothyroidism 4. Diabetes mellitus

SYSTEMIC LUPUS ERYTHEMATOSUS • Etiology and Pathophysiology • Clinical Manifestations § § § § Dermatologic manifestations Musculoskeletal problems Cardiopulmonary problems Renal problems Nervous system problems Hematologic problems Infection

SYSTEMIC LUPUS ERYTHEMATOSUS • Diagnostic Studies • Collaborative Care § Drug therapy

NURSING MANAGEMENT: SYSTEMIC LUPUS ERYTHEMATOSUS • Nursing Assessment • Nursing Diagnoses • Planning

NURSING MANAGEMENT: SYSTEMIC LUPUS ERYTHEMATOSUS • Nursing Implementation § § § Health promotion Acute intervention Ambulatory and home care Lupus and pregnancy • Psychosocial issues • • Evaluation

ARE YOU READY? A client is suspected of having SLE. The nurse monitors the client for which of the following initial characteristic signs of SLE? 1. Weight gain 2. Subnormal temperature 3. Elevated RBCs 4. Rash on face across bridge of nose and cheeks

FIBROMYALGIA SYNDROME • Etiology and Pathophysiology • Clinical Manifestations and Complications • Diagnostic Studies • Collaborative Care

NURSING MANAGEMENT: FIBROMYALGIA SYNDROME • Support from health care team • Massage • Heat/cold applications • Yoga/Tai Chi • Dietary changes • Relaxation therapy • Counseling