26 Questions
What is one reason for performing a joint fluid analysis?
To diagnose the specific type of arthritis occurring within a joint
What is the primary goal of neurovascular status monitoring?
To assess circulation, motion, and sensation in the injured extremity
In managing a muscle strain, what is typically initiated in 2-5 days?
Passive and active exercises
What is the significance of checking for crystals in the joint fluid?
To diagnose gouty arthritis
What is the purpose of applying heat intermittently for 15-30 minutes, 4 times a day?
To relieve muscle spasm and promote vasodilation
What is a potential treatment for severe sprains?
Surgical repair
Why is joint fluid analysis important in diagnosing arthritis?
To determine the specific type of arthritis
What is a common cause of a muscle strain?
Improper use or overstretching
What is the primary purpose of injecting a contrast material during arthrography?
To reveal the presence of hemarthrosis
What should a patient avoid doing for 8 to 12 hours before an open biopsy?
Eating or drinking
What is the recommended elevation duration for the biopsy site after the procedure?
24 hours
Why is it essential to monitor the biopsy site for edema, bleeding, and pain?
To identify potential complications
What is the primary purpose of using ice packs after the biopsy procedure?
To prevent the development of hematoma
What is the recommended duration for keeping the biopsy site dry after the procedure?
48 hours
What should a nurse do if a patient is pregnant and scheduled for an arthrography procedure?
Notify the physician
What is the primary purpose of removing jewelry before an arthrography procedure?
To prevent interference with the procedure
What is the benefit of using COX-2 inhibitors over other NSAIDs?
They are less likely to cause gastric irritation and ulceration.
What is the goal of prescribing medication to a patient with advanced, unremitting RA?
To relieve pain and improve the quality of life.
What is the primary risk factor for developing OA?
Age.
What is the primary clinical manifestation of OA?
Joint stiffness.
What is the name of the surgical procedure that involves the excision of the synovial membrane?
Synovectomy.
What is the goal of prescribing methotrexate to a patient with RA?
To slow down disease progression.
What is the primary pathophysiological mechanism of OA?
Cartilage degradation and bone stiffening.
What is the diagnosis of RA based on?
A combination of clinical manifestations and x-ray findings.
What is the treatment for gout?
Medications to reduce uric acid production.
What is the primary laboratory test used in the diagnosis of gout?
Uric acid level.
Study Notes
Reasons for Procedure
- Diagnose and treat a painful, swollen, fluid-filled joint
- Diagnose specific type of arthritis, such as rheumatoid arthritis (RA)
- Check for crystals in joint fluid, a sign of gouty arthritis (GA) / gout
Joint Injury and Treatment
- Severe sprain may require surgical repair and cast mobilization
- Monitor neurovascular status (circulation, motion, sensation) of the injured extremity
- Apply heat intermittently after 24-48 hours to relieve muscle spasm and promote vasodilation
- Strain (muscle pull) may require passive and active exercises in 2-5 days, depending on severity
- Rest, ice, compression, and elevation (RICE) may be necessary
Arthrography/Arthrogram
- Contrast material is injected to study the joint space on an x-ray image
- Reveals presence of hemarthrosis (bleeding into the joint cavity) or infection
- Nursing considerations: notify physician if patient is pregnant, remove jewelry, and monitor for edema, bleeding, and pain
Rheumatoid Arthritis (RA) Treatment
- Medication programs: antirheumatic agents (antimalarials, gold, penicillamine, or sulfasalazine), cyclo-oxygenase inhibitors, and methotrexate
- Formal program with occupational and physical therapy
- Reevaluate medication program periodically and make changes as needed
Osteoarthritis (OA)
- Most common and frequently disabling joint disorder
- Classification: primary (no prior event or disease related to OA) and secondary (resulting from previous joint injury or inflammatory disease)
- Pathophysiology: affects articular cartilage, subchondral bone, and synovium
- Risk factors: increasing age, obesity, previous joint damage, repetitive use, anatomic deformity, and genetic susceptibility
- Clinical manifestations: pain, joint stiffness, and limited range of motion
Gouty Arthritis (GA)
- Elevated serum uric acid level
- Joint x-rays show damage consistent with gouty arthritis
- Recurrent attacks of pain and swelling in the joints
- Uric acid is not excreted by the body, leading to urate formation and accumulation in the joints
This quiz covers the reasons behind joint aspiration procedure, including diagnosing and treating painful joints, identifying arthritis types, and checking for crystals in joint fluid.
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