2. OBJECTIVES
In the end of presentation learners will be able to,
Define Arthritis .
Discuss the common types of arthritis with signs and symptoms
.
Define the causes of arthritis .
Explain the medical management and nursing management of
arthritis.
Describe Nursing diagnosis related to arthritis.
3. Arthritis means inflammation or swelling of one or more
joints. it describes more than 100 conditions that affect the
joints, tissues around the joint, and other connectivetissues.
specific symptoms vary depending on the type of arthritis,
but usually include joint pain and stiffness.
(C.D.C)
4. SOME COMMON TYPES ARE THERE WE
DISCUSS
Osteo arthritis
Rheumatoid arthritis
Psoriatic arthritis
Gout
Lupus
5. 1. OSTEO ARTHRITIS
Osteoarthritis is the most common form
of arthritis, affecting millions of people
worldwide. It occurs when the protective
cartilage that cushions the ends of your
bones wears down over time.
Although osteoarthritis can damage any
joint, the disorder most commonly affects
joints in your hands, knees, hips and
spine.
6. In normal joints, a firm, rubbery material called cartilage covers the
end of each bone. Cartilage provides a smooth, gliding surface for joint
motion and acts as a cushion between the bones. In OA, the cartilage
breaks down, causing pain, swelling and problems moving the joint.
As OA worsens over time, bones may break down and develop
growths called spurs. Cartilage may chip off and float around in the
joint. In the body, an inflammatory process occurs and cytokines
(proteins) and enzymes develop that further damage the
cartilage. In the final stages of OA, the cartilage wears away and
bone rubs against bone leading to joint damage and more pain.
7. Who’s Affected?
Although osteoarthritis occurs in people of all ages, osteoarthritis is
most common in people older than 65. Common risk factors include
increasing age, obesity, previous joint injury, overuse of the joint,
weak thigh muscles, and genes.
One in two adults will develop symptoms of knee osteoarthritis during
their lives.
One in four adults will develop symptoms of hip osteoarthritis by age
85.
One in 12 people 60 years or older have handosteoarthritis
8. RHEUMATOID ARTHRITIS
Rheumatoid arthritis (RA) is an
autoimmune disease in which the
body’s immune system – which
normally protects its health by
attacking foreign substances like
bacteria and viruses – mistakenly
attacks the joints. This creates
inflammation that causes the
tissue that lines the inside of
joints (the synovium) to thicken,
resulting in swelling and pain in
and around the joints. The
synovium makes a fluid that
lubricates joints and helps them
move smoothly.
9. Who’s Affected by
Rheumatoid Arthritis?
Nearly three times as many
women have the disease as
men. In women, RA most
commonly begins between
ages 30 and 60. In men, it
often occurs later in life.
Having a familymember
with RA increases the odds
of having RA; however, the
majority of people with RA
have no family history ofthe
disease.
Rheumatoid arthritis
causes
• exposure to certain types
of bacteria, such as those
associated with
periodontal disease.
• having a history of viral
infections like infection
with the Epstein-Barr virus
which causes mononucleo
sis.
• trauma or injury, such as
bone breakage or fracture,
dislocation of a joint, and
ligament damage.
10. 3. PSORIATIC ARTHRITIS
Psoriatic arthritis is a condition that combines the
swollen, sore joints of arthritis with psoriasis. Psoriasis
typically causes itchy, scaly red patches to appear on the
skin and scalp.
OR
Psoriatic arthritis is a type of arthritis that develops
in some people with the skin condition psoriasis. It
typically causes affected joints to become inflamed
(swollen), stiff and painful.
Like psoriasis, psoriatic arthritis is a long-term
condition that can get progressively worse. In severe
cases, there's a risk of the joints becoming permanently
damaged or deformed, which may require surgical
treatment.
11. PSORIATIC ARTHRITIS
Psoriatic arthritis occurs when your body's immune system begins to
attack healthy cells and tissue. The abnormal immune response causes
inflammation in your joints
Physical trauma or something in the environment — such as a viral or
bacterial infection — may trigger psoriatic arthritis in people with an
inherited tendency.
12. GOUT
Gout is a form of inflammatory arthritis that
develops in some people who have high
levels of uric acid in the blood. The acid can
form needle-like crystals in a joint and
cause sudden, severe episodes of pain,
tenderness, redness, warmth and swelling.
13.
14. SIGN & SYMPTOMS
The signs and symptoms of gout almost always occur suddenly, and often at night.
They include:
• Intense jointpain.
• Gout usually affects the large joint of your big toe, but it can occur in anyjoint.
• Other commonly affected joints include the ankles, knees, elbows, wrists and fingers.
• The pain is likely to be most severe within the first four to 12 hours after it begins.
• Inflammation and redness. The affected joint become swollen, tender, warm and red.
• Limited range of motion.
• As gout progresses, you may not be able to move your joints normally.
15. 1. PREVENTIONS:
1.DRINK PLENTY OF FLUIDS:
Stay well-hydrated, including plenty of water. limit how many sweetened beverages you
drink, especially those sweetened with high-fructose corn syrup.
2.LIMIT OR AVOID ALCOHOL:
Talk with your doctor about whether any amount or type of alcohol is safe for you. recent
evidence suggests that beer may be particularly likely to increase the risk of gout symptoms,
especially in men.
3.GET YOUR PROTEIN FROM LOW-FAT DAIRY PRODUCTS:
Low-fat dairy products may actually have a protective effect against gout, so these are
your best-bet proteinsources.
4.MAINTAIN A DESIRABLE BODY WEIGHT:
Choose portions that allow you to maintain a healthy weight. losing weight may decrease
uric acid levels in your body. but avoid fasting or rapid weight loss, since doing so may
temporarily raise uric acid levels.
16. LUPUS
Lupus is a systemic autoimmune
disease that occurs when your
body's immune system attacks
your own tissues androgens.
Inflammation caused by lupus.
Lupus can affect many different
body system __
Including your joints, skin,
kidneys, blood cells, brain, heart
and lungs
17.
18. CAUSES
• Lupus occurs when your immune system attacks healthy tissue in your body
(autoimmune disease). It's likely that lupus results from a combination of your genetics
and your environment.
• Sunlight. Exposure to the sun may bring on lupus skin lesions or trigger your internal
response in susceptible people.
• Infections. Having an infection can initiate lupus or cause a relapse in some people.
• Medications. Lupus can be triggered by certain types of blood pressure. medications, anti-
seizure medications and antibiotics. People who have drug induced lupus usually get better
when they stop taking the medication. Rarely, symptoms may persist even after the drug is
stopped.
19.
20. ANALGESICS
GENERAL PAIN KILLERS (ANALGESICS) ease mild to moderate
pain but don’t do anything for inflammation (hot, swollen
joints).
ACETAMINOPHEN (TYLENOL) is available over the counter and is
often used for arthritis because it doesn’t hurt your heart and
stomach the way nonsteroidal anti-inflammatory agents
(nsaids) can. but too much can harm your liver.
21. NONSTEROIDALANTI-INFLAMMATORY DRUGS(NSAIDS)
NSAIDS relieve pain and inflammation by blocking hormone-like substances
called prostaglandins.
NAPROXEN (ALEVE), ASPIRIN AND IBUPROFEN (MOTRIN, ADVIL) are
available over the counter. others INDOMETHACIN (INDOCIN) AND
CELECOXIB (CELEBREX) require a prescription.
{NSAIDS CAN INCREASE YOUR CHANCES OF HAVING A HEART
ATTACK, STROKE OR A STOMACH BLEED.}
22. CORTICOSTEROIDS
Sometimes called steroids or glucocorticoids, reduce inflammation by
acting like your natural hormone cortisol. they work quickly so are good for
short-term relief. But they can create problems like weight gain, cataracts
and high blood pressure. if you need to take them for a long time, your doctor
will have you take only a small amount eachday.
23. OPIOIDS
Are pain killers that must be prescribed by a doctor. they are very strong and can
work well for severe pain. but they do have more side effects than acetaminophen
and people can become dependent on them or addicted. Donald Miller, pharm D,
professor, department of pharmacy practice at north Dakota state university in Fargo
warns they are not much more useful for long-term use than acetaminophen or
nsaids.
24.
25. NURSING DIAGNOSIS FOR PATIENTS WITH ARTHRITIS
:- ACUTE PAIN /CHRONIC PAIN
:- IMPAIRED PHYSICAL MOBILITY
:- ACTIVITY INTOLERANCE
:- RISK OR INJURY
RELATED TO:
.BONEDEFORMITIES
. MUSCLES SPASM
. JOINT DEGENERATION
. PHYSICAL MOBILITY
27. NURSING INTERVENTION
ASSESS THE CLIENT’S DESCRIPTION OF PAIN.
The client may report pain in the fingers, hips, knees, lower lumbar
spine, and cervical vertebrae.
Pain is usually provoked by activity and relieved by rest; joint pain and
aching may also be present when the client is at rest.
Pain may manifest as an ache, progressing to sharp pain when the
affected area is brought to full weight-bearing or a full range of motion
(rom). the client may experience sharp, painful muscle spasms.
28. DETERMINE WHETHER THE CLIENT IS REPORTINGALL OF
THE PAIN HE OR SHE IS EXPERIENCING.
Clients who have become accustomed to living with chronic pain may
learn to tolerate basal levels of discomfort and only reports those
discomforts that exceed these “normal” levels. The care provider is not
getting an accurate picture of the client’s status if this pain is not
reported. The nurse may need to be sensitive to nonverbal cues that pain
is present.
29. APPLY A HOT OR COLDPACK.
HEAT REDUCES PAIN THROUGH IMPROVED BLOOD FLOW TO THE
AREAAND THROUGH THE REDUCTION OF PAIN REFLEXES. SPECIAL
ATTENTION NEEDS TO BE GIVEN TO PREVENTING BURNS WITH THIS
INTERVENTION. COLD REDUCES PAIN, INFLAMMATION, AND MUSCLE
SPASTICITY BY DECREASING THE RELEASE OF PAIN-INDUCING
CHEMICALS AND SLOWING THE CONDUCTION OF PAIN IMPULSES.
THESE INTERVENTIONS REQUIRE NO SPECIAL EQUIPMENT AND CAN
BE COST-EFFECTIVE. HOT OR COLD APPLICATIONS SHOULD LAST
ABOUT 20 TO 30 MIN/HR.
30. MEDICATE FOR PAIN
BEFORE ACTIVITYAND
EXERCISE THERAPY.
EXERCISE IS NECESSARY TO
MAINTAIN JOINT MOBILITY, BUT
CLIENTS MAY BE RELUCTANT TO
PARTICIPATE IN EXERCISE IF THEY
ARE IN TOO MUCH PAIN.
31. REFERENCES :
Arthritis foundation (www.arthritis.org)
www.VersusArthritis.com
www.nhu.uk/condition/psoriaticarthritis.
The Centers for Disease Control and Prevention (CDC)
https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-
causes/syc-20350772
https://www.medicinenet.com/arthritis/article.htm
