Nursing Care of patients with arthritis Kunyakorn Muadmu

Nursing Care of patients with arthritis Kunyakorn Muadmu Orthopaedic Register Nurse Nan Hospital

Arthritis � Greek ; Arthro – joint + it is – inflammation � Most common in elderly � 2 nd most common chronic condition in the US (1 st = sinusitis) � 20 – 30% of people over age 70 suffer from OA of the Hip

Cause of arthritis � Injury � Infection � Hyperuricemia � Collections of urate crystals in soft tissue � Osteoarthritis � Immunodeficiency

Nursing care � Rheumatoid arthritis � Gouty arthritis � Osteoarthritis

Rheumatoid arthritis Nursing diagnosis � Pain � Stiffness of joint � Fatigue � Functional impairment � Limited ROM � Anxiety, Depression

Rheumatoid arthritis Nursing care � Rest � Splint � Heat 15 – 30 minute � Warm shower � Massage muscle around the joint reduce morning stiffness

Rheumatoid arthritis Nursing care � Medication � Glove � Exercise � Education � Diet NSAIDs, Antirheumatic drugs

Anti-inflammatory Diet Best sources : Colorful foods such as blueberries, Blackberries, Strawberries, Kale and Bloccoli

Anti-inflammatory Diet Fill up on fiber Avoid process food snacks lower CPR cookies, chip, other

Gout Accumulation of Monosodium urate crystal in both synovial fluid and cartilage

Risk factors for development of gouty arthritis � Age › Increase with age › Usually > 50 years onset � Race › African american > White � Sex � � Male > Female Genetics › Amount of uric acid excreted by kidneys influenced by genetics

Risk factors for development of gouty arthritis � Lifestyle factors › Heavy consumption of alcohol (especially beer) › Red meat, sea food › High fructose corn syrup › Purine – rich food › Certain vegetable › Obesity › Low consumption of dairy products

Risk factors for development of gouty arthritis � Medications › Diuretics (thiazide, loop diuretics) › Low dose aspirin › Ciclosporin › Niacin › Pyrazinamide › Ethambutol

Risk factors for development of gouty arthritis � Comorbidities › Metabolic syndrome › Hypertension › Cardiovascular disease › CKD

Burden of Gouty arthritis � Disability › Self care › Recreational › Work › Activities › Social activities � Economic � Quality of life

Gout Nursing diagnosis � Acute pain/ chronic related to tissue distension by fluid accumulation/ inflammation, joint destruction � Impaired physical mobility related to skeletal deformities, pain, discomfort, activity intolerance, decreased muscle strength

Gout Nursing care � Rest � Splint � Warm bath or shower heat enhance muscle relaxation, mobility, reduce pain and stiffness � Ice – cold compress relieve pain, swelling during the acute period

Gout Nursing care � Diet gram : BW 1 kg � Anti – gout diet low fat milk, Protein (amino acid) < 1

Nursing care for patients with Osteoarthritis

Osteoarthritis � Sign & Symptoms › Stiffness › Pain › Cracking or clicking, Crepitation › Limit ROM › Joint swelling › Joint deformity › Gait disturbance

Osteoarthritis � Nursing care › Rest › Heat › Splint › Massage › Medication NSAIDs Paracetamol, TWC, Tramol,

Osteoarthritis � Gait assistant devices

Osteoarthritis � Gait assistant devices › Avoid heavy lifting › Exercise 10% BW strengthening exercise help maintain and improve muscle strength › Activity modification

Osteoarthritis � Nursing care › Weight control › Diet Vitamin C – slow progression of OA › Ditch the heels OA › Prepare for surgery increase risk of developing

Septic Arthritis