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JBorrero 10/10

MusculoskeletalStressors

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Arthritis

Degenerative Joint Diseases Arthritis= joint inflammation.

Arthralgia= joint painDifferent types of arthritis:

Osteoarthritis

Rheumatoi arthritis!outy arthritis

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Osteoarthritis

"ost #ommon form of arthritis$ noninflammatory$nonsystemic isease

One or many joints un ergo egenerative anprogressive #hanges$ mainly %t. &earing joints.'tiffness$ ten erness$ #repitus an enlargement

evelop.Deformity$ in#omplete islo#ation an synovialeffusion may eventually o##ur.(reatment: rest$ heat$ i#e$ anti inflammatory rugs$

e#rease %t. if in i#ate $ inje#ta&le #orti#osteroi s$surgery.

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Osteoarthritis- Risk Factors

AgeDe#rease mus#le strength

O&esity)ossi&le geneti# ris*+arly in isease pro#ess$ OA is iffi#ult to ,

from RA-, of (rauma to joint

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OA- Signs and Symptoms

Joint pain and stiffness that resolves withrest or inactivity

)ain %ith joint palpation or ROJ"repitus in one or more joints+nlarge joints

-e&er en s no es enlarge at istal ) jointsBou#har s no es lo#ate at pro,imal )

joints

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Osteoarthritis- !

)harma#otherapy3 tylenol$ 4'A D'$ A'A$ o,35inhi&itors

ntra3arti#ular inje#tions of #orti#osteroi s!lu#osamine3 a#ts as a lu&ri#ant an sho#*a&sor&ing flui in joint$ helps re&uil #artilageBalan#e rest %ith a#tivity

6se &ra#ing or splints Apply thermal therapies Arthroplasty3 joint repla#ement #an relieve pain anrestore loss of fun#tion for patients %ith a van#e

isease.

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Auto-"mmune #isease

nflammatory an immune response are normallyhelpfulB6( these responses #an fail to re#ogni7e self #ellsan atta#* normal &o y tissues.

alle an auto3immune responsean severly amage #ells$ tissues an organs

+!. RA$ '2+$ )rogressive systemi# s#lerosis$#onne#tive tissue isor ers an other organ spe#ifi#isor ers

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Rheumatoid Arthritis

hroni#$ systemi#$ progressive inflammatoryisease of the synovial tissue$ $ilateral%

involving numerous joints.'ynovitis3%arm$ re $ s%ollen joints resultingfrom a##umulation of flui an inflammatory#ells.

lassifie as autoimmune pro#ess+,a#er&ations an remissionsan #ause severe eformities that restri#t

fun#tion

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RA- Risk Factors

8emale gen er Age 50390 years

!eneti# pre isposition+pstein Barr virus'tress

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Rheumatoid Arthritis- #!

Rheumatoi 8a#tor anti&o y3 -igh titers#orrelate %ith severe isease$ 0; pts.

Antinu#lear Anti&o y 0; pts.

+'R: +levate $ mo erate to severe elevation Artho#entesis3 synovial flui aspirate &ynee le

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RA & Signs and Symptoms

Joints3 &ilateral an symmetri# stiffness$ ten erness$s%elling an temp. #hanges in joint.)ain at rest an %ith movement)ulses3 #he#* peripheral pulses$ use oppler ifne#essary$ #he#* #apillary refill.+ ema3 o&serve$ report an re#or amt. an lo#ationof e ema.RO"$ mus#le strength$ mo&ility$ atrophy

Anore,ia$ %eight loss8ever3 generally lo% gra e

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RA- Sign and Symptoms

1. 8atigue3 unusual fatigue$ generali7e %ea*ness5. Morning stiffness lasting longer than '( minutes

after rising% su$sides with activity .?. Re $ %arm$ s%ollen$ painful joints@. 'ystemi# ' '9. )ain3 at rest an %ith movement

hat shoul %e monitorC

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Rheumatoid Arthritis- !

Rest$ uring ay3 e#rease %t. &earing stress.RO"3 maintain joint fun#tion$ e,er#ise %ater.

"e i#ation3 analgesi# an anti3inflammatory

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)ursing "nterventions

Assist %ith/en#ourage physi#al a#tivity)rovi e a safe environment

6tili7e progressive mus#le rela,ationRefer to support groups+motional support

A" Assistive evi#es-ome #are nee s

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+outy ArthritisEery painful joint inflammation$ s%ollen an re ene)rimary3 n&orn error of uri# a#i meta&olism3 in#reases pro u#tionan interferes %ith e,#retion of uri# a#i'e#on ary3 -yperuri#emia #ause &y another isease+,#ess uri# a#i #onverte to so ium urate #rystals anpre#ipitate from &loo an &e#ome eposite in joints3 tophi or in*i neys$ renal #al#uli(reatment:"e s3 #ol#hi#ine$ 4'A D'$ n o#in

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Systemic ,upusrythematosus

'2+3 hroni# nflammatory isease affe#ting manysystems.

omen &et%een 1 3@0$ &la#*F%hite$ #hil &earing

years Autoimmune pro#ess3 anti&o ies rea#t %ith D4A$immune #omple,es form3 amage organs an &loovessels.

n#lu es: vas#ulitisG renal involvementG lesions of s*inan nervous system$ photosensitivity$ oral ul#ersnitial manifestation3 arthritis$ $utterfly rash $

%ea*ness$ fatigue$ %t. loss

'ymptoms an t,. epen on systems involve .

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Systemic ,upusrythematosus

)athologi# #hanges3Autoimmune pro#ess1. Eas#ulitis in arterioles an small arteries5. !ranulomatous gro%ths on heart valves3 non &a#terial

en o#ar itis.?. 8i&rosis of the spleen$ lymph no e a enopathy@. (hi#*ening of the &asement mem&rane of glomerular

#apillaries.9. >0; s%elling an inflammatory infiltrates of synovial

mem&rane.H. Renal3 2upus nephritisI. )leural effusion or )4

. Raynau s phenomenon3 a&out 19; #ases>. 4euro3 psy#hosis$ paresis$ migraines$ an sei7ures

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S, #!

A4A3 hallmar* test$ in > ; pts."e i#ations3

4'A D'

Antimalarial me s3 hy ro,y#hloroKuine

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Systemic ,upus- ducation

+n#ourage to avoi un ue emotional/ physi#alstress an to get enough rest Alternate e,er#ise planne rest perio s.(ea#h ho% to re#ogni7e the symptoms of a flare(ea#h ho% to prevent an re#ogni7e infe#tion

Avoi sunlight$ use suns#reen+at a %ell &alan#e iet$vitamins an iron.+sta&lish short term goals(ea#h re: me s."e s avoi 3 )ronestyl$ -y rala7ine.