Osteoporosis and Osteoarthritis

a metabolic bone disorder that occurs when the creation of new bone doesn’t keep up with the removal of old bone and causes bones to become weak and brittle

osteoporosis

what is the cause of primary osteoporosis?

genetic or environmental

thin, lean body build is a precursor to…

low bone density

being a female is a risk factor for osteoporosis. What specifically causes it?

low estrogen

osteoporosis risk factors:
low ___ or ____ ____ consumption
high ___, low ___ intake
excess ___
history of ____ disorders
lack of ___ ___ or prolonged ____

calcium
vitamin D
phosphorus
protein
caffeine
malabsorption
physical exercise
immobility

what are secondary osteoporosis causes?

comorbidities or chronic medication use

what are the comorbidities that can cause secondary osteoporosis?

hyper/hypothyroidism
DM
Cushings
RA
bone cancer

what are the medications that can cause secondary osteoporosis?

loop diuretics
corticosteroids
thyroid
anticonvulsants

what are two examples of long-term lack of weight bearing that can cause secondary osteoporosis?

spinal cord injury
sedentary lifestyle

What is the acronym for osteoporosis risk factors?

Alcohol use
Corticosteroid use
Calcium low
Estrogen low
Smoking
Sedentary lifestyle

what happens to height when you have osteoporosis?

reduced by 5-7.5 cm (2-3 in)

what happens after lifting and bending when you have osteoporosis?

acute back pain

what happens to your movement and spine when you have osteoporosis?

restriction in movement
spinal deformity (kyphosis)

what body parts are more prone to fractures in osteoporosis?

wrist
femur
thoracic spine

when a person has osteoporosis and is being palpated during assessment, what happens when an affected area is palpated?

pain occurs

how is osteoporosis diagnosed?

bone density test (DEXA scan)

a diagnostic tool used to measure bone density and assess the risk of osteoporosis and fractures.

DEXA scan

how is osteoporosis treated?

prevention and early screening

what medications are given for osteoporosis?

calcium and vitamin D

what are the complications of osteoporosis?

falls and fractures

Nonsystemic, noninflammatory deterioration of the articular cartilage of the bones (cartilage destruction) that affects mostly weight-bearing joints — knees and hips in overweight clients

osteoarthritis

happens due to “wear and tear” on the joints
(risk factors: old age, obesity, repetitive stress, genetics)

osteoarthritis

joint pain due to grating of the bones, bone break down, bone spur formation, and cartilage/bone spurs floating in the joint space

osteoarthritis

chronic, progressive inflammatory disease that attacks the joints producing an inflammatory synovitis
(risk factors: bacterial or viral infection, stress/smoking, environmental)

rheumatoid arthritis

involved joints bilaterally, symmetrically, and systemically (starting in upper joints first)

rheumatoid arthritis

what is the acronym for the manifestations of osteoarthritis?

outgrowths (on hands)
stiffness (and joint pain)
tenderness
experience (grating of the bone)
only the joints

what are the manifestations for RA? (7 S)

sunrise stiffness
soft
swelling
symmetircal
synovium
systemic
stages

nodes on fingers from bone spurs

outgrowths

found on the distal interphalangeal joint

Heberden’s node

found on the proximal interphalangeal joint

Bouchard’s node

in OA, when do they experience tenderness?

when touching the joint site with bony outgrowths

joints in OA are…

asymmetrical and uneven

what are the stages of RA?

synovitis, pannus, akylosis

what are the diagnostic tests for Osteoarthritis?

X-ray (bone not cartilage)
Ct and MRI (knee and vertebrae)
ESR and CRP

what does ESR and CRP look like in OA?

increased due to secondary synovitis

What are the diagnostic testing indicators of Rheumatoid Arthitis?

Anti-CCP antibodies
Positive RF (Rheumatoid Factor)
ESR and CRP
X-ray
Arthrocentesis

what would an X-Ray show for someone with RA?

joint deterioration

this diagnostic finding is more sensitive than Rheumatoid factor, and can be positive before manifestations

Anti-CCP antibodies

synovial fluid asperation (WBC and RF present in fluid)

arthrocentesis

Medications for Osteoarthritis:

A____
T_____ medications
N___
O_____
M_____ R_____
A______ therapies

acetaminophen
topical
NSAIDs
Opioids
muscle relaxers
alternative

what are the surgical interventions for osteoarthritis?

total joint arthroplasty (replacement)
intra-articular injections
osteotomy

a surgical procedure where a bone is cut to realign, shorten, or lengthen it

osteotomy

delivering medication directly into a joint to treat inflammatory conditions

intra-articular injections

a procedure where a damaged or diseased joint is replaced with a prosthesis (artificial joint) to alleviate pain and improve function

total joint athroplasty (or replacement)

What are the medications used for Rheumatoid Arthritis?

NSAIDs
Corticosteroids
DMARDs

what are the surgical interventions used for Rheumatoid Arthritis?

Total joint athroplasty (or replacement)
synovectomy

a surgical procedure where inflamed synovial tissue (the membrane lining a joint) is removed to reduce pain and improve joint function

synovectomy

Osteoarthritis Nursing Management:
- Determine the ___ ___
- Assess need for _____ or ______ devices
- Balance ____ with ____
- ____ v ____ therapy
- Healthy ____
- Adhere to ____ _____ consistently
- ________ care

psychosocial impact
assistive
adaptive
activity
rest
heat
cold
weight
exercise regimen
interprofessional

Rheumatoid arthritis Nursing Management:
- monitor for indication of _____
- provide a ___ ____
- monitor for _____ ____
- ______ care
- _____ v ____ therapy
- _______ energy
- report manifestations of _____

fatigue
safe environment
medication effectiveness
interprofessional
heat
cold
conserve
exacerbation

what are signs of medication effectiveness?

reduced pain and increased mobility

what are manifestations of rheumatoid arthritis exacerbation?

fever
infection
pleuritic pain
substernal pain