Osteoarthritis was depicted as not so much of a serious issue, but today it is more often used to describe a joint failure. It is not only an unavoidable result of aging but the response of a single joint, or more than one joint, to an illness or injury. The condition is classified as primary where there are no apparent causes and secondary where metabolic, anatomical, traumatic, or inflammatory factors may be involved. Radiological evidence shows that 80% of the population over the age of 75 has osteoarthritis (Cooper, 1994), with the peak age of onset being 50-60.
It’s very difficult to come up with a strict term for the condition since there is a very poor correlation between radiographic, pathological, and clinical manifestations. As a consequence, it is still being treated as a miscellaneous illness issue rather than a serious disease entity. (Cushnaghan and McDowell, 1999).
Its exact aetiology and pathogenesis are unknown but osteoarthritis may be related to genetic factors, trauma, or previous joint disease. Obesity, occupation, and previous injury often determine which joints are affected and the severity of the disease.
Commonly affected parts include the knees, hips, distal interphalangeal joints, thumb base joints of the hands, and angle joints of the spine. Except for hip joints, the condition is more prevalent in women than men (Cushnaghan and McDowell, 1999). Also, read Everything You Need To Know About Aneurysm Osteoarthritis Syndrome
Osteoarthritis brings destruction of the hyaline cartilage of the bone. The aftermath of fibrocartilage and bone at the base margins increase overgrowths of bone – termed osteophytes – which are easily visible on X-rays.
Other radiological changes consist of the loss of joint space, bony cysts, and sclerosis in the subchondral bone. These changes to the bone may only cause minor inconvenience for some patients, but others could experience chronic pain and disability if left untreated (Arthur, 1998).
Coping with pain
- Pain can only be described in terms of human consciousness and, as with all sensory experiences, there is no way to be exact that any two people’s perceptions of pain are the same. It is a very exceptional, individualized, and unverifiable personal experience. But pain is also a significant contributor to the morbidity, disability, and socio-economic price of musculature and skeleton-related disorders.
- Pain controlling requires the nurse to carry out an individual assessment. There is no blueprint for controlling chronic pain and the nurse would have to discuss a program with the patient that matches their physical, psychological, and social needs. Regular assessment of the program is crucial to make advancements and to prevent the patient from feeling demotivated and helpless since breakthroughs in symptoms will only happen over some time.
- An osteoarthritis advancement program should have to cover areas such as physical exercise and analgesia, and also proper weight management. Intra-articular injections of corticosteroid can be used in some instances (purely optional) if there is proof of inflammation.
- Patients who are experiencing pain because of osteoarthritis often omit their activity levels in an attempt to protect their bodies from experiencing further pain. This has the exact reverse effect, as times of inactivity escalate joint pains and stiffness, and also causes muscle weakness and wasting.
- The patient frequently feels trapped in a cycle of pain. They are hesitant to do the necessary exercises because they feel like it could complicate their pain, but being dormant itself will escalate the pain.
- Patients need to be soothed that the pain they endure when they exercise will not worsen their condition. The pain is an innate reaction to muscles and joints that have become stiff because of inactivity and it will reduce when the body grows habituated to regular exercise.
- It is often at this condition that the patient requires a check-up from a physiotherapist for support and management for an exercise program and also to inspire and motivate them to carry on exercising for as long as it takes.
- Any exercise program needs to be introduced slowly and then make it part of the said patient’s daily routine. Swimming could be very useful as a starting point, as the buoyancy of the water will support the joints, making every movement painless.
- Exercise also needs to be a little bit of fun when the patient has to continue doing it. At the Staffordshire Rheumatology Centre, a support group uses the hydrotherapy pool one evening per week. Patients with osteoarthritis and other forms of arthritis not only continue their exercises regularly but also meet other people socially. Pain can and will isolate people and exercising in a group helps a lot to build up social contacts.
- Patients frequently find it tough to change already established behaviour patterns. Fatigue is often an additional issue that comes with pain that will surely affect the patient’s mood and behaviour.
- Planning daily tasks is important so that periods of activity are alternated with periods of rest, and it not only helps to reduce the pain and fatigue but will also surely improve the patient’s coping abilities.
Combating Inactivity Stiffness:
This can be eased by daily alteration of positions and engaging in easy stretching exercises, so it puts the body through a various range of movements.
Overweight patients will have more pain than average patients in weight-bearing joints, especially the knees and lower back. It is crucial to keep them as mobile as possible to help with their weight and pain reduction.
In patients over 65, the side effects sometimes outweigh the potential useful effects of non-steroidal anti-inflammatory medicines, although their use may be considered if the condition initiates a flare-up of inflammatory symptoms. But here, their use would be much applicable in the short term only to avoid the case of gastric and renal complications.
Group management programs:
- Patients benefit from group programs where they develop coping skills in a supportive, positive environment and also learn from other patients who have the same condition.
- Lorig et al (1987) found that such programs enable participants to get excitedly self-manage of their condition.
- Patients with osteoarthritis should be nursed in a variety of ways. The nurse will require both bits of knowledge, the compassion of the management for the trouble to deliver care that is evidence-based and remedially effective.
FAQs about Osteoarthritis nurse teaching:
Ans. The main goals for the nursing intervention are pain control and optimal working ability.
Weight loss: Weight loss is a very essential approach to pain and disability advancement.
Assistive devices: Canes and other perambulatory devices are very useful for perambulation.
Exercising: Exercises such as walking have to start kindly and increase step by step.
Analgesic: Decent pain management is integral to the accomplishment of an exercise program.
Physical therapy: A referral of physical therapy classes for patients with such issues will be very beneficial.
Ans: Nursing administration of the patient with osteoarthritis consists of both nonpharmacologic and pharmacologic strategies.
Physical assessment: Evaluation of the area over the affected bone joint could disclose delicate and increased joints.
Patient history: The nurse should take see for any kind of past injury of the joints because this is a serious distress factor for OA.
Based on the assembled data, nursing conclusions are:
Excruciating pain relating to swelling of the synovium and irritation of the nerve fibers.
Activity intolerance related to joint pain.
Impaired physical mobility related to joint stiffness.
Nursing Care Planning and Goals-
After healthy management, a patient with osteoarthritis will:
Correlate negative factors affecting the exercising intolerance and omit or decrease their development when possible.
Use identified techniques to enhance activity intolerance.
Report measurable increase in activity intolerance.
Report pain is relieved or controlled.
Follow prescribed pharmacologic regimen.
Participate in ADLs and desired activities.
Ans: The goals of treatment are to:
Diminish joint pain and stiffness and hold back additional progress.
Improve mobility and function.
Increase patients’ quality of life.
The type of treatment regimen specified in prescription is the calculation of various factors, consisting of patient’s age, general health, activities, livelihood, and assessment of current condition.
Ans: After the accomplishing of the care plan, success should be assessed if the client:
Associated negative factors harming activity intolerance and omit or reduce their aftermath when possible.
Used identified techniques to enhance activity intolerance.
Reported measurable increase in activity intolerance.
Reported pain is relieved or controlled.
Followed prescribed pharmacologic regimen.
Participated in ADLs and desired activities.