Aging (usually, late middle life and older).
Obesity or excessive joint use.
Systemic diseases (hemophilia or due to organ transplantation.
b. Pathological changes include thinning cartilage, which exposes bone to
articulating surfaces, and thickened synovial membrane. The fibrous tissue around the
joint ossifies. Ankylosis does not occur. Signs and symptoms of osteoarthritis are:
Pain in one or more joints, particularly after exercise and long periods of
Stiffness in the morning or at night.
Limitation of joint motion.
c. The goal of patient care is relief of pain and discomfort. Rest of the affected
joints and short periods of moderate exercise are helpful. Heat to the affected part may
afford some relief of pain. Obese patients should lose weight. Analgesics are given for
pain control. Anti-inflammatory agents are prescribed when synovial inflammation is
present. Assistive devices such as splints, braces, cervical collars, or corsets are
provided as necessary. Surgical procedures are used to repair or replace painful,
d. Nursing care implications include administering medications as prescribed,
application of heat as ordered, assessing and reporting the postoperative patient's
status, and educating the patient regarding the disease.
a. Gout is a disease manifested by an acute inflammation of a joint. It occurs
most often in men over 40. Primary gout is a metabolic disorder in which the body is
unable to properly metabolize purines. Purines are end products of the digestion of
certain proteins. This inability results in deposit of urate crystals (a salt of uric acid) in
the joint and connective tissues. Secondary gout is an acquired disease resulting in
underexcretion of uric acid. It occurs because of impaired renal function precipitated by
trauma or prolonged use of diuretic agents, aspirin, or alcohol.