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What is osteoarthritis (OA)?

The most common form of joint disease in North America, characterized as a slowly progressive noninflammatory disorder of the diarthrodial joints.

How many Americans are affected by osteoarthritis?

21 million Americans, with numbers expected to increase as the population ages.

Is osteoarthritis considered a normal part of aging?

No, it is not considered a normal part of aging, although growing older is a risk factor.

At what age can cartilage destruction begin in osteoarthritis?

Cartilage destruction can begin between ages 20 and 30, with the majority of adults affected by age 40.

What are the two types of osteoarthritis?

Idiopathic disorder and secondary disorder.

What factors can lead to secondary osteoarthritis?

Trauma, mechanical stress, inflammation, joint instability, neurologic disorders, skeletal deformities, hematologic/endocrine disorders, and certain drugs.

What hormonal change is linked to osteoarthritis?

Estrogen reduction at menopause.

How does obesity relate to osteoarthritis?

Obesity is a linked risk factor for developing osteoarthritis.

What effect does regular moderate exercise have on osteoarthritis?

It decreases the risk of developing osteoarthritis.

What happens to cartilage in osteoarthritis?

It becomes dull, yellow, granular, soft, less elastic, and less able to resist wear.

What is the primary symptom of osteoarthritis?

Joint pain, which can range from mild discomfort to significant disability.

How does joint pain change in the early and later stages of osteoarthritis?

In early stages, rest relieves pain; in later stages, pain occurs even at rest and sleep is disturbed.

What is crepitation in the context of osteoarthritis?

A grating sensation caused by loose cartilage particles in the joint cavity, indicating loss of cartilage integrity.

Which joints are most commonly affected by osteoarthritis?

Joints of the fingers (DIP, PIP, MCP), weight-bearing joints (hips, knees), MTP joint of the foot, and cervical/lower lumbar vertebrae.

What are Heberden's nodes?

Osteophytes that form on the distal interphalangeal joints of the fingers, appearing as small nodules.

What diagnostic tools are used for early osteoarthritis?

Bone scan, computed tomography (CT) scan, and magnetic resonance imaging (MRI).

What do X-rays detect in progressed osteoarthritis?

Joint space narrowing, bony sclerosis, and osteophyte formation.

What is the foundation for managing osteoarthritis?

Nonpharmacologic interventions, with drug therapy serving as an adjunct.

What is the role of arthroscopic surgery in osteoarthritis treatment?

It is effective for repairing ligament tears and removing bone or cartilage bits, but debridement is usually not recommended.

What is the importance of balancing rest and activity for osteoarthritis patients?

Patients must rest affected joints during acute inflammation and maintain them in a functional position.

How can heat and cold applications help osteoarthritis?

Heat can reduce stiffness, while ice is appropriate for acute inflammation.

What are the systemic manifestations of osteoarthritis?

There are no systemic manifestations like fatigue, fever, or organ involvement, which distinguishes OA from inflammatory joint disorders.

What is the significance of joint deformity in osteoarthritis?

Deformities can appear as early as age 40 and may include visible disfigurement without significant loss of function.

What is the effect of knee osteoarthritis on leg alignment?

It can lead to joint malalignment, resulting in a bowlegged appearance and altered gait.

What is the role of routine blood tests in osteoarthritis?

They are useful for screening related conditions and establishing baselines for therapy, but no specific laboratory abnormalities or biomarkers have been identified.

What are some non-pharmacological therapies for osteoarthritis?

Hot packs, whirlpool baths, ultrasound, and paraffin wax baths.

Why is exercise important for osteoarthritis patients?

Exercise is fundamental for managing osteoarthritis and helps preserve articular cartilage integrity.

What is a critical component of a weight-reduction program for overweight osteoarthritis patients?

Exercise is essential to reduce load on joints.

What are some complementary and alternative therapies for osteoarthritis?

Acupuncture, yoga, massage, guided imagery, therapeutic touch, and nutritional supplements like glucosamine and chondroitin sulfate.

What medication is recommended for mild to moderate joint pain in osteoarthritis?

Acetaminophen (1000 mg every 6 hours) and topical agents like capsaicin cream or salicylates.

What is the treatment for moderate to severe joint pain in osteoarthritis?

Nonsteroidal anti-inflammatory drugs (NSAIDs).

What should be assessed and documented in patients with osteoarthritis?

Joint pain and stiffness, including type, location, severity, frequency, and duration.

What factors should be considered when evaluating osteoarthritis symptoms?

The extent to which symptoms affect daily activities and the duration and success of treatments.

What are some common nursing diagnoses for osteoarthritis patients?

Acute and chronic pain, impaired physical mobility, self-care deficits, and chronic low self-esteem.

What are the overall goals for osteoarthritis management?

Maintain or improve joint function, achieve independence in self-care, and manage pain through pharmacologic and nonpharmacologic strategies.

What is a key focus of community education for osteoarthritis prevention?

Alteration of modifiable risk factors such as weight loss and safety in physical activities.

What are common complaints of osteoarthritis patients?

Pain, stiffness, limitation of function, and frustration with physical difficulties.

What role do health assessment questionnaires play in osteoarthritis management?

They help pinpoint areas of difficulty and develop treatment goals based on updated data.

What should be included in patient and family teaching for osteoarthritis management?

Information about the disease, pain management, correct posture, body mechanics, and joint protection principles.

What modifications can be made in home and work environments for osteoarthritis patients?

Remove scatter rugs, provide railings, use night lights, and ensure well-fitting support shoes.

What are expected outcomes for osteoarthritis patients?

Adequate rest and activity, satisfactory pain management, and maintenance of joint flexibility and muscle strength.

What should a patient verbalize to show acceptance of osteoarthritis as a chronic disease?

Collaboration with healthcare providers in disease management.

What should patients with osteoarthritis do to relieve morning stiffness?

Use heat to relieve stiffness.

What type of physical activity is advisable for a patient with knee pain from osteoarthritis?

Low-impact activities, such as Tai Chi, emphasizing the importance of warming up.

What is a common physical finding in osteoarthritis patients?

Crepitation in the affected joints.

What should be emphasized in a therapeutic exercise program for osteoarthritis?

Principles of joint protection and energy conservation.

What is the importance of assistive devices for osteoarthritis patients?

They help improve mobility and safety, such as canes, walkers, and grab bars.

What is a common misconception about osteoarthritis deformities?

Patients should be assured that deformity is not a usual course of osteoarthritis.

What should a patient with osteoarthritis avoid regarding glucosamine?

Avoid the misconception that glucosamine has no therapeutic value; it may be beneficial.