Osteoarthritis
What causes cartilage to swell in the early stages of osteoarthritis?
Chondrocytes
RA is a chronic systemic inflammatory disorder caused by this type of immune dysfunction.
autoimmune activation
What is the most recognizable skin manifestation of SLE that appears on the face?
What is a malar (butterfly) rash?
What is the diagnostic test used to confirm osteoporosis, and what does it measure?
What is a DEXA scan (Dual-energy X-ray absorptiometry), which measures bone density in the hip and spine?
What class of drugs is used in short-term flare management for RA and SLE but not for long-term use due to side effects?
What are corticosteroids?
After cartilage swells in response to damage, it begins to lose elasticity and undergoes these two structural changes during early OA progression.
What are they?
flake and form clefts
What environmental trigger is strongly linked to the onset of RA?
smoking
What environmental exposure should patients with SLE be taught to avoid?
What is ultraviolet (UV) light?
What T-score from a DEXA scan is classified as osteoporosis?
What is a T-score of less than -1 - -2.5?
What is the key difference between how NSAIDs and DMARDs are used in treating RA?
NSAIDs relieve symptoms only;
DMARDs slow disease progression and prevent joint damage.
List three joints commonly affected by osteoarthritis
hand, hip, knee, spine
This abnormal membrane develops in RA and leads to cartilage and bone destruction.
What is this?
Pannus
What is the mechanism of action and the serious side effects of Hydroxychloroquine (Plaquenil®) that requires immediate attention?
Blurry Vision (which can lead to loss of eyesight if not treated)
What are the daily recommended intakes of calcium and vitamin D to help prevent osteoporosis?
What is 1,500 mg of calcium and 800 IU of vitamin D per day?
How does cold therapy help in managing symptoms of connective tissue disorders like RA?
It reduces inflammation and pain during flares.
what medications are used for treatment in OA?
Intra-articular corticosteroid injection
Topical NSAIDS
Oral NSAIDS
Which clinical feature helps distinguish RA from OA in the duration of morning stiffness?
OA stiffness typically resolves in under 30 minutes.
What urinalysis findings indicate kidney involvement in SLE (lupus nephritis)?
What are proteinuria and cellular casts?
What hormone change in women is most responsible for accelerated bone loss?
What is the loss of estrogen after menopause?
Estrogen normally inhibits bone resorption by osteoclasts.
What labs should be monitored in a patient with SLE who is at risk for renal complications, and why?
Urinalysis – to check for proteinuria and casts
Serum creatinine – to evaluate kidney function
Renal biopsy – to confirm lupus nephritis and guide treatment
What would you expect to see on an X-ray of a patient with advanced OA?
narrowing joint space , osteophytes
Name three non-pharmacological management strategies used in RA care
Heat or cold therapy (heat for stiffness, cold for inflammation)
Splints
Therapeutic exercise/PT/OT (ROM, muscle strengthening, conditioning)
What is the mechanism of action of Belimumab, and when is it used in SLE?
What is an inhibitor of B lymphocyte stimulator that reduces antibody formation, used in lupus nephritis or serious organ involvement?
Name two surgical interventions used to treat vertebral fractures in osteoporosis.
What are vertebroplasty and kyphoplasty? Vertebroplasty: injection of cement.
Kyphoplasty: balloon inserted, then cement added to restore shape.
A female patient of childbearing age is prescribed methotrexate for rheumatoid arthritis. What key teaching must the nurse provide regarding reproductive health and why?
to use birth control because Methotrexate is teratogenic, meaning it can cause fetal abnormalities, miscarriage, or birth defects.