c. Patient education and quality nursing care are important, but the nursing staff
must be aware of how the patient feels about the amputation. Trying to compensate for
a lost limb is a difficult adjustment for anyone to make. It can easily produce feelings of
uselessness or inadequacy in the patient. How "handicapped" the patient feels will
depend upon how he adjusts to the loss. Some patients may refuse to learn to care for
the stump, or even look at it, while others may be eager to reach a speedy recovery.
Each patient will require individualized assistance in learning to cope with his
amputation. It is important for the nursing personnel to remember that any amputation
results in a permanent loss that may interfere with the psychological, physical, or social
needs of the individual.
Section X. RHEUMATOID ARTHRITIS, OSTEOARTHRITIS, AND GOUT
1-53. CONNECTIVE TISSUE DISORDERS
The musculoskeletal system consists of bones, muscles, joints, tendons,
ligaments, cartilage, and bursae. These connective tissue structures are responsible for
movement, storing calcium, producing blood cells, and protection and support of many
organs. Arthritis, gout, and other related diseases can be collectively referred to as
connective tissue disorders. Inflammation and subsequent destruction of these tissues
result in joint dysfunction, secondary to pain with movement, and possible joint
deformity. Any organ or body system may be affected by connective tissue disorder; for
example, lungs, heart, and blood vessels.
1-54. RHEUMATOID ARTHRITIS
a. Rheumatoid arthritis is a chronic, progressive disease that affects the
cartilage surface of the joints and other collagen tissues throughout the body. It is
characterized by recurrent inflammation of the lining of joints (synovitis). This leads to
formation of a tissue that adheres to the opposite joint surface, inhibiting motion (fibrous
ankylosis). The restricting band of tissue becomes calcified, causing destruction of the
joint (osseous ankylosis). See figure 1-21.
Figure 1-21. Pathological changes in rheumatoid arthritis.