Osteoarthritis
This type of tissue normally provides a smooth, protective surface between bones in a synovial joint
This type of disease occurs when the immune system mistakenly attacks the body's own tissues
What is an autoimmune disease
This surgery replaces damaged surfaces of the knee joint with artificial components
These crystals accumulate in joints and cause the inflammatory response associated with gout
What are monosodium urate crystals
These cells break down or resorb bone during normal bone remodeling
This class of medications included ibuprofen and naproxen and can reduce pain and inflammation
What are NSAIDS
This term described a grinding or crackling sensation felt or heard when a joint moves
What is crepitus
A patient after a joint replacement suddenly becomes short of breath and reports chest pain. What could the patient be developing?
What is a PE
These activities include bathing, dressing, toileting, eating and transferring
What are ADLs
A patient has bilateral knee pain, crepitus, and brief morning stiffness. Which disorder best fits this pattern?
What is osteoarthritis
This common disorder involves progressive changes in cartilage, underlying bone, and other joint structures
What is osteoarthritis
This joint structure becomes inflamed in rheumatoid arthritis and may develop thickened inflammatory tissue.
What is the synovial membrane
This is the primary functional goal of joint replacement beyond simply changing the appearance of the joint
What is reducing pain and improving mobility and function
This joint at the base of the great toe is a classic location for an acute gout attack
What is the first metatarsophalangeal joint
These cells build new bone
What are osteoblasts
This medication is commonly used to treat acute gout inflammation and can cause diarrhea and other GI effects
What is colchicine
This symptom pattern - symmetric hand-joint swelling and prolonged morning stiffness - suggest his disorder
What is RA
A patient with a cast develops new numbness and a cool extremity. What should the nurse do?
What is perform an immediate neurovascular assessment and urgently escalate the new findings
This healthcare profesisonal commonly evaluates gait, balance, transfers, strength and walking device needs
Who is the physical therapist
A patient has symmetric wrist swelling, fatigue and 90 minutes of morning stiffness. Which disorder best fits this pattern?
What is rheumatoid arthritis
These bony growths may develop around joints affected by osteoarthritis
What are osteophytes, or bone spurs
Symmetric swelling of the wrist and finger joints with morning stiffness lasting 90 minutes suggests this disorder
What is rheumatoid arthritis
These exercises and interventions help reduce venous stasis after surgery
What are ankle pumps, prescribed leg exercises and early mobilization when appropriate
A patient develops sudden, severe great-toe pain, redness, warmth, and swelling overnight. This disorder is likely.
This diagnostic study measures bone mineral density and is commonly used to diagnosis osteroporosis
What is a DXA scan
This medication reduces bone resorption and is commonly used to treat osteoporosis
What is alendronate (a bisphosphonate)
This term described the loss of normal joint movement caused by pan, stiffness or structural changes
What is limited range of motion
A patient after a joint replacement has increasing wound drainage, tachycardia and hypotension. What complication is the priority concern?
What is hemorrhage
This healthcare professional helps patients adapt bathing, dressing and other daily activities using techniques and adaptive equipment
Who is the occupational therapist
A patient has a sudden red, swollen great toe. Which disorder best fits the pattern?
What is gout
A patient with knee OA avoids walking because of pain. Over time, the patient develops weakness and reduced endurance. What intervention is important for this patient?
What is individualized therapy to preserve strength and mobility
These two laboratory markers may support assessment of inflammation in RN, although neither is specific to the disease
What are ESR and CRP
A patient develops unilateral leg swelling, warmth, and pain after hip replacement. This complication must be considered.
What is a DVT
This blood test may support long term gout assessment but cannot independently confirm or exclude an acute flare
What is serum urate level
These are three common sites of osteoporotic fragility fractures
What are the vertebrae, hip and distal radius (wrist)
This RA medication is generally taken weekly, and accidental daily dosing can cause severe toxicity
What is methotrexate
This assessment includes sensation, movement, skin temperature, color, capillary refill and pulses as appropriate
What is a neurovascular assessment
A patient has a fever and a rapidly worsening hot, swollen joint. What potentially life-threatening diagnosis must be considered?
What is septic arthritis
These devices may reduce joint loading and improve stability for patients with limited mobility
A patient with osteoporosis asks why treatment is needed when they have no pain. What is the best explanation?
What is osteoporosis can remain asymptomatic while bone strength decreases and treatment aims to reduce fracture risk
A patient with knee OA has localized pain and a history of chronic kidney disease and peptic ulcer disease. This treatment may reduce systemic exposure compared with an oral NSAID, although risks remain.
What is a topical NSAID such as diclofenac, if appropriate for the patient
This tissue, formed by proliferating inflamed synovium, can invade and damage cartilage and bone.
What is pannus
A patient become pale and dizzy with tachycardia and increasing surgical drainage. This complication is the priority concern.
What is postoperative hemorrhage
This medication reduces urate production and is commonly used for long-term gout managment
What is allopurinol
This hormone decline after menopause contributes to increased bone resorption
What is estrogen
This is the major reason patients taking biologic DMARDs need infection screening and monitoring
These medications suppress or modify immune responses and can increase the risk of serious infections
A patient has a hot, swollen joint and fever. Why is it unsafe to assume the patient is simply having a gout flare?
Because septic arthritis can produce similar findings and requires urgent evaluation
A patient after hip replacement has sudden severe hip pain and an abnormal leg position. What is the safest action?
What is prevent further movement, support the limb, and obtain urgent assistance for suspected dislocation
This intervention helps maintain strength, flexibility and mobility in many patients with OA
What is individualized exercise and physical therapy
A patient with RA reports a fever while receiving a biologic DMARD. What is the safest nursing response?
What is prompt evaluation for infection and escalation to the treating clinician; do not dismiss the fever as a routine medication effect
This image finding commonly appears on an X-ray of an osteoarthritic joint as cartilage deteriorates.
What is joint space narrowing
A patient prescribed methotrexate for RA says they take it every morning. What is the nurse's safest response?
What is verify the prescription and urgently clarify the regimen because methotrexate is generally taken weekly and daily dosing can be fatal
What is hip dislocation. Prevent further movement, support the limb, and obtain urgent assistance.
A patient with a gout flare has fever and a very hot, swollen knee. What dangerous condition must not be overlooked?
What is septic arthritis, which requires urgent evaluation
A patient taking alendronate asks how to take it safely. What key instructions should the nurse provide?
What are take it as directed with plain water on an empty stomach and remain upright for at least 30 minutes
A patient receiving a corticosteroid injection for OA has diabetes. Which parameter many need closer monitoring after the injection?
What is blood glucose because corticosteroids can cause temporary hyperglycemia
What term described a patient with a unilateral calf swelling, warmth and redness?
What is a DVT
A patient taking methotrexate mistakenly took it daily for several days and now has mouth sores and unusual bruising. What is the priority?
What is urgent medical evaluation for possible methotrexate toxicity
A patient with osteoporosis is afraid to exercise because of fracture risk. What is the best general nursing approach?
What is encourage appropriate weight bearing resistance and balance activities tailored to the patient's fracture risk and abilities, with professional guidance when needed
A patient with osteoporosis has a T-score of -2.7 and a history of a vertebral fracture. What are the major goals of the treatment plan?
What are reducing future fracture risk, selecting appropriate pharmacological therapy, ensuring adequate calcium and vitam D, improving safe mobility and reducing falls
A patient with OA takes ibuprofen daily and has HTN, CKD and a previous GI bleed. What is the primary medication concern.
What is increased risk of renal injury, GI bleeding and worsening blood pressure or cardiovascular risk. The regimen needs clinician review.
A patient taking hydroxychloroquine for RA needs this type of monitoring because of potentially serious adverse effect.
What is recommended ophthalmologic screening for retinal toxicity
What is an immediate neurovascular assessment and urgent escalation for possible neurovascular compromise
A patient beginning urate-lowering therapy asks why an anti-inflammatory medication might also be prescribed.
When starting or adjusting urate-lowering therapy, it can trigger flares so temporary anti-inflammatory prophylaxis may be recommended
A t-score of -2.7 in an appropriate adult population meets the densitometric definition of this condition
What is osteoporosis
A patient taking allopurinol develops a new rash. What should the nurse teach the patient to do?
Seek prompt medical evaluation and not take another dose until advised by the clinician because a serious hypersensitivity reaction is possible
A patient is scheduled to ambulate after joint replacement but has an unclear weight-bearing order. What should the nurse do?
What is clarify the prescribed weight bearing status before assisting the patient to stand or walk
A patient with osteoporosis falls and cannot bear weight but there is no obvious deformity. What should the nurse do?
What is suspect a fracture, avoid forcing weight bearing, assess the patient and arrange urgent evaluation
What is occupational therapy. They can teach joint-protection techniques and use adaptive equipment to preserve independence.
A patient two days after hip replacement develops a fever, increasing wound drainage, and worsening pain. What should the nurse consider and what is the priority?
What is possible surgical site or prosthetic joint infection; promptly assess the patient and escalate for clinical evaluation
A patient with severe knee OA has persistent pain despite appropriate conservative treatment and can no longer complete ADLs. What treatment option may be considered, and what is its goal?
What is total knee arthroplasty, intended to reduce pain and improve function when appropriate
A patient with RA reports less pain after starting an NSAID and wants to stop their DMARD. What is the best teaching point?
What is NSAIDs can relieve symptoms but do not prevent progressive joint damage; the patient should not stop prescribed DMARD therapy without consulting the prescriber
A patient is medically stable after hip replacement but cannot transfer, climb necessary stairs, or manage personal care independently. Which team members can help assess and address these limitation?
Who are the physical therapist and occupational therapist, working with nursing and the broader discharge-planning team
This procedure can identify urate crystals in joint fluid and may also help evaluate suspected joint infection
What is joint aspiration with synovial fluid analysis and culture when indicated
An older adult with osteoporosis has a new severe backache after lifting a light basket, along with height loss and a prior fragility fracture. What is the priority concern and next step?
What is a possible vertebral compression fracture requiring prompt clinical evaluation, including pain, neurologic, and mobility assessment
A patient with advanced chronic kidney disease is prescribed denosumab for osteoporosis. Which electrolyte abnormality is a particularly important concern and what should the nurse verify before administration?
What is hypocalcemia. Verify that calcium is appropriately assessed and corrected and that the prescribed monitoring plan addresses the increased risk in advanced kidney disease
A patient reports new thigh or groin pain while receiving long term bisphosphonate therapy. What rare complication should be considered?
What is an atypical femoral fracture, which requires clinical evaluation
A patient after a hip replacement is suddenly hypoxemic and confused. The nurse is deciding between finishing routine documentation and activating emergency assistance. What takes priority?
What is emergency assistance and immediate ABC assessment and support
A patient has improved pain after joint replacement but is becoming weaker because they remain in bed most of the day. What is the best nursing response?
What is assess barriers to mobility, address pain and safety concenrs, coordinate progressive activity and rehabilitation, and monitor functional progress
A 78 yr old patient with osteoporosis falls, develops severe hip pain and cannot bear weight. The patient also takes an anticoagulant. Identify the major concerns and the immediate nursing priorities.
What are possible hip fracture and potential bleeding complications. Prevent further injury, assess ABC's, obtain urgent medical evaluation, assess for bleeding, and avoid unnecessary movement or weight-bearing