NUR 502 Module 6 Discussion Musculoskeletal and Neurological function

NUR 502 Module 6 Discussion

Musculoskeletal and Neurological function

 Osteoarthritis is defined by inflammation of the joints as seen in conditions such as Rheumatoid Arthritis (RA) and Juvenile Arthritis (JA). Osteoarthrosis, on the other hand, refers to pathological changes to the joint, such as cartilage loss or joint space narrowing, that often happen as part of the aging process.  

Osteoarthritis

 Osteoarthritis (OA) tends to be a disease that manifests with age due to wear and tear on the joints. The disease is thought to be precipitated by a reduction in the synthesis of synovial fluid and cartilage as people age (Jeremic et al., 2021). This results in less lubrication for the joint and a narrowing of the joint space leading to more friction and damage to the cartilage. As the cartilage erodes, it is unable to repair itself and causes progressively worse pain, stiffness, and decreased range of motion. The symptoms are usually seen in the hands and then the knees are the next joints to become affected. Joints may become enlarged due to hypertrophy of the joint capsule, and there may also be crepitus in the joint. The joint pain tends to be exacerbated during and after movement and is relieved with rest.

Rheumatoid Arthritis

 Rheumatoid arthritis (RA) differs from OA in that it is a systemic autoimmune inflammatory process that can affect other organs in the body. It attacks the synovial membrane, causing synovitis, cartilage erosion, and fibrosis. It often starts with an acute episode, which recovers with time the progresses with periods of exacerbation and remission. Like OA, the most common place for symptoms of RA to start is the hand. Synovitis affects the vasculature, and vascular flow becomes impeded, resulting in loss of shape and alignment of the joint (Dlugasch & Story, 2020). RA manifests with pain and stiffness. However, unlike osteoarthritis, due to its systemic effects, patients with RA may also have fatigue, anorexia, weight loss, depression, renal disease, and other effects. Laboratory testing for RA includes Rheumatoid factor, and cyclic citrullinated peptide antibody (CCP antibody). Antinuclear autoantibodies (ANA) and C-reactive protein (CRP) can also be checked, but they are non-specific for the disease.

Patient Interventions

Ms. GJ has a diagnosis of osteoarthritis and has been complaining of pain. I would recommend that she take the anti-inflammatory Celebrex to help with her pain. She is also encouraged to do low-impact exercises like water aerobics, available at the local YMCA. She is also encouraged to take glucosamine and chondroitin as they may provide some benefit. The patient would be educated on the progressive effects of the disease and encouraged to try heat and cold therapy to alleviate pain.

References

Dlugasch, L., & Story, L. (2020). Applied Pathophysiology for the Advanced Practice Nurse. Jones and Bartlett Learning.

Jeremić, D., Gluščević, B., Rajković, S., Jovanović, Ž., & Krivokapić, B. (2021). Osteoarthritis, osteoarthrosis and osteoarthropathy: What is the difference? Srpski medicinski casopis Lekarske komore, 2(1), 25–32. https://doi.org/10.5937/smclk2101015j