NURS 5335 FNP2 - Module 4 Study Guide.

STUDY GUIDE MSK OA and RA What are the signs and symptoms of Osteoarthritis?  Destruction of cartilage and narrowing of the joint space  Most common in females after 55  Fingers, knees, hips and spine most commonly affected joints (most common fingers)  Usually asymmetrical joint pain that develops slowly and accompanies or follows physical activity  Morning stiffness that lasts 1 hour, resumes at end of the day or after activity  Joints are cool with possible crepitus  Osteophytes, or bony enlargements, form in the joints  treat conservatively with exercise, heat etc. followed by acetaminophen and NSAIDS, followed by steroid injections.  If pain is still present refer to rheumatologist What are Heberden’s and Bouchard’s nodes? Where are they located?  Heberden’s: Bony bumps on the finger joint closest to the fingernail  Burchard’s: Bony bumps on the middle joint of the finger What are the treatments for Rheumatoid and Osteoarthritis?  RA o Non-pharm  Exercise program  Splinting  Orthotics to prevent deformities  Functional insoles  Cold therapy for analgesic, anti-inflammatory effect  Heat therapy for relaxation and circulatory stimulation  Consider Mediterranean diet  Maintain or achieve healthy BMI  Avoidance of allergens  Surgery: arthroscopy with synovectomy, arthroplasty o Pharm  Disease-modifying antirheumatic drugs (DMARDs) (Enbrel, Methotrexate)  Anti-TNF Agents (initiate after trial of 2 DMARDs)  NSAIDS, COX-2 Inhibitors  OA o Non-pharm  USE FIRST  Weight loss  Education on therapy and muscle strengthening