Nursing Management of Arthritis and Fibromyalgia
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Questions and Answers

What is the most commonly affected demographic by Fibromyalgia Syndrome, according to the assessment findings?

  • Middle-aged women (correct)
  • Teenagers
  • Young adults
  • Elderly men

    • Which of the following medications may be utilized to alleviate symptoms of Fibromyalgia?

  • Beta-blockers
  • Narcotics
  • Antihistamines
  • Antidepressants (correct)

    • Which of the following is NOT a common characteristic of Gout?

  • Inflammation in joints
  • Continuous joint stiffness (correct)
  • Affects men more than women
  • Often presents in the feet

    • Which of the following complementary alternative therapies is suggested for managing Fibromyalgia symptoms?

    <p>Acupuncture</p> Signup and view all the answers

    What is the primary goal of nursing management for patients with Fibromyalgia Syndrome?

    <p>Decrease pain and improve sleep</p> Signup and view all the answers

    Which characteristic is NOT typically associated with osteoarthritis?

    <p>Warmth of joints</p> Signup and view all the answers

    In managing rheumatoid arthritis, which one of the following is primarily focused on inflammation suppression?

    <p>Immunosuppressants</p> Signup and view all the answers

    What is the primary goal of surgical management in osteoarthritis?

    <p>Restoring function and relieving pain</p> Signup and view all the answers

    Which assessment finding is least likely to be present in a patient suffering from rheumatoid arthritis?

    <p>Painless bony nodules</p> Signup and view all the answers

    Which dietary consideration would be most beneficial for individuals with inflammatory joint disorders?

    <p>Increased omega-3 fatty acids</p> Signup and view all the answers

    Which diagnostic test is primarily used to measure inflammation in the body associated with rheumatoid arthritis?

    <p>Erythrocyte sedimentation rate (ESR)</p> Signup and view all the answers

    Which condition best describes the joint changes observed in osteoarthritis compared to rheumatoid arthritis?

    <p>Primarily related to degenerative changes</p> Signup and view all the answers

    What is the primary purpose of DMARDS in the context of inflammatory arthritis?

    <p>To decrease joint inflammation</p> Signup and view all the answers

    Which of the following are considered risk factors for Systemic Lupus Erythematosus (SLE)?

    <p>Female sex, particularly in Black American women</p> Signup and view all the answers

    What is a key diagnostic finding that specifically indicates multi-system involvement in a patient suspected of having SLE?

    <p>Positive ANA test</p> Signup and view all the answers

    Which symptom is NOT typically associated with discoid lupus?

    <p>Hematuria</p> Signup and view all the answers

    Which of the following is a common management strategy for SLE to alleviate symptoms and prevent exacerbations?

    <p>Reducing exposure to triggering factors like sunlight</p> Signup and view all the answers

    Which blood test finding is more specific for SLE diagnosis?

    <p>Positive anti-dsDNA antibody</p> Signup and view all the answers

    What is the primary role of symptom management in the context of osteomyelitis?

    <p>To immobilize the affected bone and administer antibiotics</p> Signup and view all the answers

    Which assessment finding is indicative of a potential infection in osteomyelitis?

    <p>Elevated leukocyte count and ESR</p> Signup and view all the answers

    What type of infectious agent is most commonly associated with osteomyelitis?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Which inflammatory disorder is characterized by widespread chronic pain lasting at least 3 months and is most prevalent among middle-aged women?

    <p>Fibromyalgia syndrome</p> Signup and view all the answers

    What is a common characteristic that distinguishes Gout from other arthritic conditions?

    <p>Manifests through inflammatory reactions primarily in the feet</p> Signup and view all the answers

    In the context of nursing management for Fibromyalgia, which of the following is an emphasized role for nurses?

    <p>Providing emotional support and lifestyle encouragement</p> Signup and view all the answers

    Which statement regarding systemic lupus erythematosus (SLE) is accurate?

    <p>It can involve multi-systemic manifestations</p> Signup and view all the answers

    What is an effective complementary alternative therapy for patients managing Fibromyalgia symptoms?

    <p>Acupuncture</p> Signup and view all the answers

    Which assessment finding is most indicative of rheumatoid arthritis?

    <p>Chronic morning pain</p> Signup and view all the answers

    What is the primary purpose of anti-inflammatory medications in the management of rheumatoid arthritis?

    <p>To decrease joint inflammation</p> Signup and view all the answers

    In which condition are Heberden’s and Bouchard’s nodes commonly observed?

    <p>Osteoarthritis</p> Signup and view all the answers

    Which laboratory test is primarily used to identify an autoimmune disorder such as systemic lupus erythematosus (SLE)?

    <p>Antinuclear antibody test</p> Signup and view all the answers

    What is the primary aim of disease-modifying antirheumatic drugs (DMARDs) in treating rheumatoid arthritis?

    <p>Preventing joint deformities</p> Signup and view all the answers

    Which of the following findings is least likely to be present in a patient with fibromyalgia?

    <p>Painless nodules</p> Signup and view all the answers

    What treatment method is commonly included in the management of conditions like buritis?

    <p>Intra-articular injections</p> Signup and view all the answers

    In which autoimmune condition is the rheumatoid factor found in approximately 80% of cases?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    Which symptom is often associated with Systemic Lupus Erythematosus (SLE) but not typically with other rheumatic diseases?

    <p>Butterfly rash</p> Signup and view all the answers

    What is a common feature of Discoid Lupus that distinguishes it from other forms of lupus?

    <p>Chronic skin rash with scaling</p> Signup and view all the answers

    In the assessment of osteomyelitis, which diagnostic finding is typically indicative of an active infection?

    <p>Elevated ESR</p> Signup and view all the answers

    Which of the following is considered a significant factor that can exacerbate symptoms of SLE?

    <p>Exposure to ultraviolet light</p> Signup and view all the answers

    Which of the following laboratory findings is most characteristic of Systemic Lupus Erythematosus?

    <p>Positive ANA test</p> Signup and view all the answers

    Which common behavioral disturbance can be associated with Systemic Lupus Erythematosus?

    <p>Hallucinations</p> Signup and view all the answers

    What is a common treatment approach used to manage symptoms in patients with osteomyelitis?

    <p>Antibiotic-impregnated beads application</p> Signup and view all the answers

    Which of the following is a distinguishing feature of Subacute Cutaneous Lupus compared to other lupus types?

    <p>Appearance of papulosquamous lesions</p> Signup and view all the answers

    Which of the following statements accurately describes gout?

    <p>It causes inflammatory reactions usually in the joints of the feet and hands.</p> Signup and view all the answers

    Which condition is primarily characterized by widespread chronic pain for at least 3 months?

    <p>Fibromyalgia syndrome</p> Signup and view all the answers

    What is the primary role of analgesics in the management of fibromyalgia?

    <p>To decrease pain and improve sleep</p> Signup and view all the answers

    In managing systemic lupus erythematosus (SLE), which of the following treatments is focused on inflammation suppression?

    <p>Non-steroidal anti-inflammatory drugs (NSAIDs)</p> Signup and view all the answers

    What type of therapy is often included in the management of conditions like bursitis?

    <p>Analgesics</p> Signup and view all the answers

    Which diagnostic finding is primarily associated with the identification of rheumatoid arthritis?

    <p>Erythrocyte sedimentation rate (ESR)</p> Signup and view all the answers

    Which of the following statements about the rheumatoid factor (RF) is true?

    <p>Approximately 80% of patients with RA test positive for RF.</p> Signup and view all the answers

    In the context of systemic lupus erythematosus (SLE), which test is primarily used to identify the presence of an autoimmune disorder?

    <p>Antinuclear Antibody test (ANA)</p> Signup and view all the answers

    Which symptom is most likely to be present during the exacerbation of fibromyalgia?

    <p>Chronic widespread pain</p> Signup and view all the answers

    Which medical management approach is NOT typically utilized for the treatment of osteoarthritis?

    <p>Immunotherapy</p> Signup and view all the answers

    Which of the following is a common characteristic of gout that distinguishes it from other inflammatory arthritis conditions?

    <p>Tophi formation</p> Signup and view all the answers

    In managing rheumatoid arthritis, which therapeutic approach primarily focuses on immune suppression?

    <p>Steroid therapy</p> Signup and view all the answers

    Which characteristic is primarily targeted by disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis treatment?

    <p>Decreasing joint inflammation</p> Signup and view all the answers

    Which condition is characterized by confusion, hallucinations, and irritability among its symptoms?

    <p>Systemic Lupus Erythematosus</p> Signup and view all the answers

    Which test finding is more specific for diagnosing Systemic Lupus Erythematosus?

    <p>Anti-dsDNA antibodies</p> Signup and view all the answers

    What is a common feature of Subacute Cutaneous Lupus that differentiates it from other lupus types?

    <p>Papulosquamous lesions</p> Signup and view all the answers

    Which factor is considered significant in exacerbating symptoms of Systemic Lupus Erythematosus?

    <p>Cigarette smoke</p> Signup and view all the answers

    In managing osteomyelitis, which treatment option is typically NOT utilized?

    <p>Corticosteroids</p> Signup and view all the answers

    Which symptom is least likely to be associated with Gout?

    <p>Proteinuria</p> Signup and view all the answers

    Which clinical sign is typically NOT associated with Systemic Lupus Erythematosus?

    <p>Muscle atrophy</p> Signup and view all the answers

    Which diagnostic method is primarily used to confirm the presence of an infection in osteomyelitis?

    <p>Bone biopsy</p> Signup and view all the answers

    Which characteristic is most likely to differentiate Gout from Fibromyalgia?

    <p>Occurrence of inflammatory reactions in joints</p> Signup and view all the answers

    Which of the following symptoms is least commonly associated with Fibromyalgia?

    <p>Joint swelling and tenderness</p> Signup and view all the answers

    What role do antidepressants play in the management of Fibromyalgia?

    <p>Alleviating pain and promoting sleep</p> Signup and view all the answers

    Which of the following factors is NOT a common trigger for the exacerbation of symptoms in Systemic Lupus Erythematosus (SLE)?

    <p>Cold weather</p> Signup and view all the answers

    In managing bursitis, which treatment method is often emphasized?

    <p>Physical therapy exercises</p> Signup and view all the answers

    Which symptom is most specifically associated with systemic lupus erythematosus (SLE)?

    <p>Classic butterfly rash</p> Signup and view all the answers

    What condition is characterized by the presence of anti-dsDNA antibodies?

    <p>Systemic lupus erythematosus (SLE)</p> Signup and view all the answers

    In systemic lupus erythematosus, which of the following manifestations can occur in the cardiovascular system?

    <p>Fluid retention</p> Signup and view all the answers

    What is a primary characteristic that distinguishes gout from other types of arthritis?

    <p>Presence of uric acid crystals</p> Signup and view all the answers

    Which factor is known to exacerbate symptoms of systemic lupus erythematosus?

    <p>Exposure to sunlight</p> Signup and view all the answers

    Which of the following abnormalities would most likely be found in a patient with osteomyelitis?

    <p>Elevated ESR</p> Signup and view all the answers

    Which symptom is NOT typically associated with fibromyalgia?

    <p>Joint inflammation</p> Signup and view all the answers

    What type of lesions are characteristic of subacute cutaneous lupus?

    <p>Papulosquamous lesions</p> Signup and view all the answers

    Which assessment finding is most indicative of rheumatoid arthritis?

    <p>Warmth of joints</p> Signup and view all the answers

    What is the main purpose of serum protein tests in the diagnosis of rheumatoid arthritis?

    <p>To identify specific autoantibodies</p> Signup and view all the answers

    What is the primary goal of physical therapy in managing rheumatoid arthritis?

    <p>To restore function and maintain mobility</p> Signup and view all the answers

    In rheumatoid arthritis, the presence of which antibody is found in approximately 80% of patients?

    <p>Rheumatoid factor</p> Signup and view all the answers

    What distinguishes osteoarthritis from rheumatoid arthritis in terms of pathological changes?

    <p>Degenerative joint changes with cartilage wear</p> Signup and view all the answers

    Which treatment method is commonly recommended for managing symptoms in patients with fibromyalgia?

    <p>Cognitive behavioral therapy</p> Signup and view all the answers

    In the context of rheumatoid arthritis, what is the primary action of DMARDs?

    <p>Alterating the course of the disease</p> Signup and view all the answers

    Which of the following is NOT a typical symptom associated with systemic lupus erythematosus (SLE)?

    <p>Frequent migraines</p> Signup and view all the answers

    Study Notes

    Introductory Medical-Surgical Nursing, 13e - Chapter 63: Caring for Clients With Orthopedic and Connective Tissue Disorders

    • Objectives: Explain differences between rheumatoid arthritis and osteoarthritis, describe nursing management of arthritis, summarize TMD clinical manifestations, define pathophysiology of gout, fibromyalgia, bursitis, and ankylosing spondylitis, delineate nursing care for these conditions, discuss systemic lupus erythematosus multisystem involvement, identify causes of osteomyelitis, explain inflammatory processes associated with Lyme disease, identify risk factors for osteoporosis and Paget's disease, differentiate between bunions and hammer toe, and discuss benign and malignant bone tumors.

    Inflammatory Disorder Arthritis

    • Arthritis: Characterized by joint inflammation and/or degeneration.
    • Osteoarthritis: Degenerative joint disease, often associated with wear and tear.
    • Rheumatoid Arthritis (RA): Autoimmune inflammatory disorder of connective tissue structures/joints. Characterized by chronicity, remissions, and exacerbations; most common sites are hands, wrists, knees, and ankles. Symmetrical, proximal joint involvement, acute onset typically in 20-40s, with genetic predisposition. Symptoms: stiffness, joint pain, warmth around joints.
    • RA Pathophysiology and Etiology: Immune system attacks joint synovial tissue, releasing cytokines causing inflammation. Can affect eyes, heart, lungs, etc.
    • RA Assessment Findings: Subcutaneous nodules, muscle atrophy, flexion contractures, classic/characteristic deformities, warm joints, chronic pain worse in morning, and weight loss.
    • RA Diagnostic Findings: Radiography, serum protein, rheumatoid factor (RF) electrophoresis, arthrocentesis, CRP. ANA.

    Inflammatory Disorders: Rheumatoid Arthritis (RA) Continued...

    • RA Medical Management: Decreasing joint inflammation, relieving discomfort, preventing deformities, restoring function. (refer to 63-1 Drug Therapy Table) Use of DMARDS.

    Joint Changes in RA

    • Diagrams showing the pannus formation and loss of cartilage in RA joints are included.

    Rheumatoid Blood Tests

    • Rheumatoid factor (RF): Type of antibody found in autoimmune disease patients. Estimated 80% found in RA patients.
    • Erythrocyte sedimentation rate (ESR): Measures inflammation in the body.
    • C-reactive protein: Measures body inflammation.
    • Antinuclear antibody (ANA) test: Detects antibodies in the nucleus of cells, identifying autoimmune disorders.

    RA Continued - Nursing Management

    • Teaching RA disease management.
    • Managing anti-inflammatory drugs
    • Steroids
    • Immunosuppressants
    • Physical therapy
    • Nutrition
    • Maintaining independence
    • Adaptive devices
    • Relaxation techniques
    • Sleep strategies

    RA Remission: By the Numbers

    • 1.5 Million adults with RA in the United States.
    • 10% to 33% remission rates for those not treated quickly or who don't use biologics.
    • 60% or higher remission rates with early and aggressive treatment.

    Inflammatory Diseases: Degenerative Joint Disease (Osteoarthritis)

    • Pathophysiology and Etiology: Repeated trauma, degenerative joint changes, usually occurring after age 40.
    • Primary Osteoarthritis: Without known cause.
    • Secondary Osteoarthritis: Known cause like injury or congenital issues.
    • Assessment Findings (Signs and Symptoms): Stiffness, pain, painless nodules. Heberden's and Bouchard's nodes (distal joints of fingers), cartilage degeneration, ROM issues crepitus, deformity, limitations, and bone spurs.
    • Diagnostic Findings: Radiography

    Osteoarthritis Management

    • Medical and Surgical Management: Rest, exercise program, transcutaneous electrical nerve stimulation (TENS) unit, drug therapy, joint surgery, intra-articular injection
    • Nursing Management: Teaching methods to reduce inflammation and pain.
    • Client teaching: Medication, weight-loss, dietary changes, avoiding stresses on joints.

    Osteoarthritis cont.

    • Exacerbated by overuse.
    • Weight bearing joint issues are often asymmetrical.
    • More common after age 40
    • Develops slowly over years.
    • Usually pain is noted with motion initially.
    • Stiffness localized to affected joints.
    • Not a systemic condition
    • No remissions

    Heberden Nodes and Bouchard Nodes

    • Diagrams depicting these joint abnormalities are included.

    Joint Changes in Osteoarthritis (Diagram)

    • Diagram showing degenerative changes in joints.

    Inflammatory Disorders: Temporomandibular Disorders (TMD)

    • Pathophysiology and Etiology: Degenerative arthritis, malocclusion, bruxism, dislocation during endotracheal intubation, or other jaw injuries and trauma.
    • Assessment Findings: Jaw pain, muscle spasms, tenderness of masseter/temporalis muscles, headache, tinnitus (ringing in ears), and ear pain.
    • Medical and Surgical Management: Dentist referral, NSAIDs, mouth guards, TENS units, muscle relaxants, tricyclics, reconstructive surgery, bite guards.
    • Nursing Management: Nutrition, teaching on foods easily consumed without chewing, nutrition consult.

    Temporomandibular Joint (Diagram)

    • Diagram illustrating the temporomandibular joint.

    Gout Hyperuricemia

    • Primary Gout: Inflammatory disorder with uric acid accumulation in the blood (hyperuricemia).
    • Excessive Ingestion of Purines: Organ meats, steak, shellfish, sardines, genetics, starvation can cause this condition to arise
    • Secondary Gout: Abnormal purine metabolism, increased rate of protein synthesis with overproduction or underexcretion of uric acid, increased cellular turnover( some anemias, leukemias, multiple myleomas, psoriasis), decreased excretion of uric acid, due to diuretics, salicylates and/or excessive alcohol intake notably beer.

    Inflammatory Disorders: Gout

    • Pathophysiology and Etiology: Inherited, painful metabolic disorder impacting joints, causing inflammatory reactions, primarily affects men>women.
    • Assessment Findings: Edema, recurrent jaw pain, tender joints/one joint, possible tophi (urate crystals), fever, possible kidney stones.
    • Diagnostic Findings: Blood work (clinical findings/urine test), arthrocentesis, radiography, or ultrasound for elevated uric acid levels.
    • Medical and Surgical Management: Uricosuric drugs, reduced purine intake, NSAIDs, colchicine, phenylbutazone, steroids (refer to relevant 63-2 Drug Therapy Table).

    Gout Management of Diet

    • Adequate protein intake with limited purine-rich foods to reduce contributing issues
    • High complex carbs and low in fats- for enhanced urate excretion/reduces fat retardation
    • Encouraging overweight clients to reduce weight.
    • Increasing fluid intake for uric acid excretion.

    Inflammatory Disorders: Fibromyalgia Syndrome

    • Pathophysiology and Etiology: Widespread inflammatory illness, unknown cause.
    • Assessment Findings: Chronic musculoskeletal pain, fatigue, sleep disturbances, commonly affects middle-aged women. Affects muscles, ligaments, and tendons.
    • Diagnostic Findings: Difficult to diagnose. Ruling out other conditions, noting widespread chronic pain for 3 months
    • Medical and Surgical Management: Analgesics, steroids, additional nontraditional therapies (refer to 63-1 Evidence Based Practice chart), rheumatologist involvement.
    • Nursing Management: Goal is to decrease pain, improve sleep. Treatments may include Antiseizure medications, antidepressants, and muscle relaxers along with Cam therapies like massage therapy, acupuncture, biofeedback, water therapy, guided imagery, mindfulness, and counseling. Education, support, encouragement to live healthy lifestyle

    Inflammatory Disorders: Bursitis

    • Pathophysiology and Etiology: Inflammation of the bursae, and may result from repetitive motion, trauma, infection, and as a reaction gout or RA.
    • Assessment Findings: Painful joint movement (elbow, knee, or shoulder), distinct lump (bursa)
    • Diagnostic Findings: Radiograph, fluid aspiration.
    • Medical and Surgical Management: Rest, salicylates, NSAIDs corticosteroid treatment. Mild ROM exercises.
    • Nursing Management: Support, teaching, and resources.

    Bursitis of the Knee

    • Diagram depicting the swollen knee joint.

    Inflammatory Disorders: Spondylitis

    • Pathophysiology and Etiology: Chronic connective tissue disorder. Progressive immobility and fusing of the vertebrae. Etiology is unknown.
    • Assessment Findings: Low back pain, flattened lumbar curve, aortic regurgitation, Permanent neck flexion, reduced lung sounds if Kyphosis develops.
    • Diagnostic Findings: ESR, CT scan, radiographs, and CX-SF.
    • Management: Primarily supportive, including medications, back brace, sleep instruction guidelines, and exercises. No cure exists with only supportive care available.
    • Nursing Management: Education and support. Increased flexibility, and strength
    • Diagram of an affected spine is included showing inflammation of the vertebrae.

    Question #1 (True or False)

    • Gout affects more women than men is False.

    Question #2 (True or False)

    • There is no cure for ankylosing spondylitis. Is True.

    Inflammatory Disorders: Systemic Lupus Erythematosus (SLE)

    • Pathophysiology and Etiology: Autoimmune disorder, unknown cause, destroying connective tissues, impacting multiple body systems (skin, joints, kidneys, heart/lungs, etc.). Chronic disease.
    • Assessment Findings: "Great Imitator" (mimics other inflammatory diseases , Lyme Disease), more frequent in Black and Hispanic/Asian women. Symptoms may include facial rash, proteinuria, hematuria, EKG changes, enlarged spleen, Raynaud's phenomenon, musculoskeletal issues, arthritis, joint swelling, and pain.
    • Lupus cont.: Discoid Lupus (chronic rash), Subacute Cutaneous Lupus (papules/scaling), and other behavioral disturbances. Confusion, hallucinations, irritability, chest pain, pericarditis, fluid retention, and renal complications. Exposure to UV light can often reactivate the disorder.
    • Medical Management: Producing remission, preventing/treating exacerbations, and medication strategies
    • Renal, cardiac, GI, and CNS symptomatic treatment
    • Diagnostic Findings: Presenting symptoms, blood tests, renal biopsy, urinalysis, Anemia, thrombocytopenia, leukopenia, positive ANA, and Anti-dsDNA testing
    • Other Test: Cardiac, GI and Respiratory changes, Epstein-Barr Virus tests.
    • Nursing Management: Client and family teaching, focuses on exacerbations to alleviate symptoms, support, education, mobility issues, safety, and skin protection from triggers. Reduce exposure to triggers (stress, smoking, UV sunlight).
    • Diagram of Butterfly Rash is included to portray the condition's presentation

    Musculoskeletal Infectious Disorders: Osteomyelitis

    • Pathophysiology and Etiology: Bacterial infection of bone tissue, often resulting from pathogens like Staphylococcus aureus.
    • Assessment Findings: Sudden, acute, or chronic infection.
    • Diagnostic Findings: Elevated leukocyte count and ESR; positive blood culture; anemia; radiographs, bone scans, MRI.
    • Medical and Surgical Management: Immobilization, surgical debridement, closed saline irrigation. Antibiotic-impregnated beads, bone/muscle flaps. Amputation is a last resort.
    • Nursing Management: Supportive care, management of the infectious process, and potential for amputation surgery.

    Musculoskeletal Infectious Disorders: Lyme Disease

    • Pathophysiology and Etiology: Tick-borne bacterial infection, impacting multiple areas (joints, brain, cardiac, skin), chronic inflammatory, multisystem disease.
    • Assessment Findings (3 Stages):
    • Stage 1: Localized rash (bull's-eye pattern); feelings of being unwell; numbness, tingling, chills, fatigue.
    • Stage 2: Symptoms become more spread out in the body; worsen; short-term memory loss.
    • Stage 3: Mental health issues are possible; MS, and fibromyalgia are some other disorders
    • Diagnostic Findings: Presentation of signs, and use of ELISA/Western blot tests.
    • Nursing Management: Supportive care, managing the infection, understanding the 3 stages of this disease
    • Diagram depicting the characteristic rash is included.

    Lyme Disease cont.

    • Diagnostic findings: based on presenting signs and symptoms; ELISA test identifies antibodies to B. burgdorferi, Western blot test needed if ELISA is positive.
    • Medical and Surgical Management: Antibiotics are important; supportive care is crucial to management prognosis. Good results are often seen in early treatment stages
    • Nursing Management(client teaching): Education on preventing Lyme disease. Ticks must be removed in 36-48 hours to be effective.

    Question #3 (True or False)

    • Lyme disease is spread via mosquito bites is False. It is spread by deer tick bites.

    Structural Disorders: Osteoporosis

    • Pathophysiology and Etiology: Loss of bone mass, more prevalent in women>men, contributing factors exist like genetic factors
    • Women: often slim framing, and postmenopausal women, from the European descent group
    • Assessment Findings: Lumbosacral, thoracic back pain, kyphosis, brittle and porous bones , bone loss affecting the vertebrae(spinal cord).
    • Diagnostic Findings: Radiography, DEXA scans.
    • Diagram of Spine is included to portray the affect on the spine.

    Osteoporosis Management

    • Medical and Surgical Management: Calcium, vitamin D, drug therapy, hormone replacement therapy (HRT), exercise, pain relief, and preventing injuries. refer to 63-3 Drug therapy, and Nutrition notes.
    • Nursing Management: Important Education on reducing bone loss includes emphasizing sufficient calcium/vitamin D intake and well-balanced foods. Wt bearing activities, medications: Bisphosphonates, calcitonin, estrone receptor modulators, HRT and Denosumab (slows bone loss), done as needed (Q6 months). The Nurse should also be aware of nutrition notes and supplements that may be useful.

    Structural Disorders: Osteomalacia

    • Pathophysiology and Etiology: Insufficient calcium absorption, and phosphate deficiency results in softening of bones.
    • Assessment Findings: Bone pain, weakness, deformities, and a waddling gait from bowed legs.
    • Diagnostic Findings: Radiography, serum levels
    • Medical and Surgical Management: Adequate nutrition and exposure to sunlight, exercise, braces, and/or surgery as needed.
    • Nursing Management: Addressing dietary deficiencies, maintaining safety precautions, and pain management techniques are necessary.

    Structural Disorders: Paget's Disease

    • Pathophysiology and Etiology: Abnormal bone remodeling. Bones grow larger, but also become weaker.
    • Assessment Findings: Bone pain, tenderness, and skeletal deformity, mostly impacting long bones (spine, pelvis, skull, legs).
    • Diagnostic Findings: Radiography, bone scans
    • Medical and Surgical Management: Drug therapy, surgery if needed( when limbs are misaligned).
    • Nursing Management: Refer to Nursing Care Plan 61-1 in Chapter 61.

    Structural Disorders: The Feet

    • Pathophysiology and Etiology: Heredity, arthritis, and improperly fitting shoes.
    • Conditions: Bunions, hammertoes, and mallet toe
    • Assessment Findings: Pain, tenderness, deformity, corns, and calluses.
    • Diagnostic Findings: Radiography
    • Medical and Surgical Management: Well-fitted shoes, exercises, pads, surgery (bunionectomy).
    • Nursing Management:Refer to 63-3 Client/Family teaching, for educational resources.
    • Diagrams of hallux valgus (bunion) and hammertoe are included.

    Benign Bone Tumors

    • Pathophysiology and Etiology: Overgrown clusters of normal bone cells.
    • Assessment Findings: Pain, deformity, swelling
    • Diagnostic Findings: Radiography, bone scans, biopsy
    • Medical and Surgical Management: Surgery, curettage (scraping), bone grafts, splints, or casts
    • Nursing Management: Supportive care, and education on potential treatments.

    Malignant Bone Tumors

    • Pathophysiology and Etiology: Radiation, toxic chemical exposure, heredity are potential factors
    • Assessment Findings: Primary tumors; unusual locations, pathologic fractures, and difficulty in movement. Abnormal gait, and pain are also symptoms to pay attention to.
    • Diagnostic Findings: Radiography, MRI, bone scans, biopsy
    • Medical and Surgical Management: Surgery, radiation, chemotherapy
    • Nursing Management: Supportive care for the patient is a necessity, as well as a focus on the treatment plan for the patient, understanding of the severity, and the importance of support and education to the patient is important

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    Description

    This quiz assesses your knowledge of the nursing management practices for patients with arthritis and fibromyalgia. It covers demographics, medications, characteristics of related conditions, and dietary considerations. Test your understanding of the primary goals and common therapies in these areas.

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