Connective Tissue Disorders
Describe the basic concepts of musculoskeletal & connective tissue
physiology
- all work together to give the body form, stability, support, and movement.
Connective tissue is a key component of the musculoskeletal system
o What are skeletal muscle, cartilage, tendons, ligaments, and bones?
o Skeletal muscle: composed of skeletal muscle fibers
o Tendons: attach muscle to bone, injuries due to overuse
o Ligaments: attach bone to bone, can rupture, less stable after injury,
capsular – part of joint capsule, extracapsular – provides stability
o Cartilage: strong flexible connective tissue, protects joints and
bones, acts as shock absorber, reduces friction and prevents bones
from rubbing together
o Bones: store calcium and release it into bloodstream when other
parts of body need it, holds the whole skeletal system together and
supports freedom of movement
Osteoarthritis (OA)
o Risk Factors = aging, obesity, joint trauma, injury, joint overuse,
female
o S/S = one sided, decreased ROM, tenderness, swelling,
o Lab tests = x-ray, labs
o Nursing actions = decrease pain, maintain mobility, prevent injury,
medications, surgical joint replacement
o PT education = take meds, report pain & bleeding, physical activity,
home health referral
o Complications = diabetes, heart failure
Rheumatoid Arthritis (RA)
o Risk Factors = family history, smoking, environmental exposure
o S/S = bilateral joints, morning stiffness, joint pain & stiffness &
swelling
o Lab tests = rheumatic factor, ANA, Radiographs, ^ ESR, ^CRP, low
hemoglobin
o Nursing actions = ROM exercises, low fat diet, increase proteins,
surgical joint replacement, medication,
o PT education = meds, follow up with doctor, monitor for infections,
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,Summer 2024 NUR 335 (Med-Surg 1) Exam 3 Study Outline
o Complications = decreased function, permanent deformity, infection,
cancer
Systemic Lupus Erythematosus (SLE)
o Risk Factors = genetics, women, AA
o S/S = fatigue, pain or swelling in joints, headaches, sensitivity to
sunlight, rash on cheeks and nose, hair loss, sores in mouth
o Lab tests = physical, antinuclear antibody lab
o Nursing actions = maintain sleep schedule, increased protein, exercise,
avoid sun, meds, surgical renal transplant and joint replacement
o PT education = recognize triggers, sunscreen, conserve energy,
immunizations, meds, monitor for infection
o Complications = renal failure, heart disease, lung disease, stroke,
increase of infection
Gout Fibromyalgia
o Risk Factors = obesity, older men, high meat and seafood diet,
thiazide diuretics, alcohol
o S/S = pain, inflammation, swelling, redness, tenderness of joint, only 1
joint
o Lab tests = uric acid
o Nursing actions = meds, diet with low meat and seafood, weight
management, no alcohol,
o PT education = maintain mobility & ROM of joint, don’t eat meats
and seafoods, no alcohol
o Complications = kidney stone
What is the difference between Osteoarthritis (OA), Rheumatoid
Arthritis (RA), and Gout? Compare and contrast. What joints are
commonly affected?
- OA is one sided, the cartilage wears down over time, and is in the hands,
knees, and spine
- RA is bilateral, the synovial fluid in the joints are attacked and is in the
hands, wrists, feet, ankles, knees, shoulders, and elbows
- Gout is crystal buildup of uric acid, and is in the big toe, ankle, knee,
elbows and wrists
What education, medications, and lifestyle modifications that can assist with
OA, RA and Gout?
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, Summer 2024 NUR 335 (Med-Surg 1) Exam 3 Study Outline
- Education = ROM exercises and mobility, physical activity but not too
much, not using the joint will cause inflammation
- Lifestyle modifications: limit alcohol, stop smoking, diet as needed
- Medications: NSAIDS, analgesics, glucocorticoids, DMARDs,
What is a rheumatic disease?
o Large group of diseases that have exacerbations and remissions, can
affect many organs, autoimmune and bilateral
What are exacerbations and remissions in the disease process?
o Chronic conditions with times of increase disease activity and little
disease activity, exac = high, remi = low
What is the autoimmune component of RA and SLE?
o RA = synovium, SLE = healthy tissue
What clinical manifestations outside of joints are common in RA and SLE?
o RA = nodules, dry eyes, dry mouth, lung disease, infections
o SLE: butterfly rash, hair loss, seizures
Why is SLE called the great imitator disorder?
o It can resemble many other diseases and conditions
What laboratory tests are indicative of RA, SLE, and the inflammatory
process?
o ANA: blood test that looks for antibodies that attack the nucleus of
healthy cells
o Rheumatic factor: measures rheumatoid factors in a sample of blood
o Erythrocyte sedimentation rate (ESR): shows general inflammation
o C-reactive protein: shows general inflammation
What are the common clinical manifestations in fibromyalgia? How can
lifestyle modifications help?
o S/S = body aches, fatigue, headache, cognitive impairment, abdominal
pain
o Lifestyle modifications = exercise, sleep study
Assessment of Respiratory Function, Oxygen Management, Upper & Lower
Respiratory Disorders; Infectious Respiratory Disorders
Describe the normal structure and function of the respiratory system
(upper & lower airways).
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