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Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018 | Registered Nurse (RN) School Study Aid

18 - Care of Patients With Arthritis and Other Connective Tissue Diseases
33 Picmonics to Learn | 54 mins
Osteoarthritis
Mechanism
Articular Cartilage Destruction
Biomechanical Stress
Aging
Signs and Symptoms
Asymmetric
Pain Decreases with Rest
Morning Stiffness Under 30 Minutes
Crepitus
DIP and PIP Joints
Treatment
Lifestyle Changes
Acetaminophen or NSAIDs
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2 mins
Osteoarthritis Assessment
Mechanism
Aging
Articular Cartilage Destruction
Biomechanical Stress
Signs and Symptoms
Asymmetric
Pain Decreases with Rest
Morning Stiffness under 30 Minutes
Crepitus
DIP and PIP Joints
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1 min
Osteoarthritis Interventions
Lifestyle Modifications
Balance Rest and Activity
Therapeutic Exercise
Heat and Cold Applications
Drug Therapy
Intra-articular Injection
NSAIDs
Considerations
Reconstructive Joint Surgery
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1 min
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly Inhibits COX
Acts Primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
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51 secs
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
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1 min
Celecoxib
Indications
Rheumatoid Arthritis
Osteoarthritis
Pain
Mechanism of Action
NSAID
Selectively Inhibits COX-2
Side Effects
Sulfa Allergy
Increased Risk of Thrombosis
GI Bleed
Contraindication
Pregnancy > 30 Weeks
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1 min
Tramadol
Indications
Chronic Pain
Mechanism of Action
Weak Opioid
Inhibit Serotonin and NE reuptake
Side Effect
Increased Risk of Seizure
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48 secs
Hip Surgery
Neurovascular Assessment
No 90 Degree Hip Flexion
No Adduction
No Internal Rotation
Avoid Turning on Affected Side
Considerations
Thromboembolism Prevention
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2 mins
Preoperative Care
Preop Education
Surgical Procedure
NPO
Turn, Cough, Deep Breathe, Incentive Spirometer
Lower Extremity Exercises
Compression Stockings or SCD's
Pain Management
Safety
Informed Consent
Physical Preparation
Preop Checklist
Handoff to Surgery
Universal Precautions
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2 mins
Erythropoietin
Mechanism
Stimulates RBC Production
Indications
Chronic Renal Failure
Anemia
Side Effects
Increased Risk of Thrombosis
Pelvic and Limb Pain
Hypertension
Considerations
Do Not Shake
Monitor Hemoglobin (Hgb) Weekly
May Accelerate Tumor Progression
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2 mins
Postoperative Care
Head to Toe Assessment
Complications
Hemorrhage
Clotting
Pain
Dehiscence or Evisceration
Respiratory Complications
Paralytic Ileus
Infection
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2 mins
Venous Thromboembolism (DVT) Interventions
Anticoagulants
Prevention Education
Frequent Ambulation
Leg Exercises
Compression Stockings or SCD's
Avoid Nicotine and Oral Contraceptives
Surgery
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1 min
Warfarin (Coumadin)
Mechanism of Action
Inhibits Clotting Factors
Indications
Atrial Fibrillation
Venous Thrombosis
Pulmonary Embolism
Assessment
PT/INR Levels
Observe for Bleeding
Contraindications
Pregnancy
Nursing Considerations
Vitamin K and Fresh Frozen Plasma
Prolonged Therapeutic Onset
Maintain Same Diet
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2 mins
Enoxaparin (Lovenox)
Mechanism of Action
Inhibits Clotting Factors
Factor Xa
Indications
Clot Formation Prevention
Side Effects
Heparin Induced Thrombocytopenia (HIT)
Bleeding
Considerations
Medication Education
Subcutaneous Injection
2 Inches from Umbilicus or Incisions
Antidote
Protamine Sulfate
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2 mins
Total Knee Replacement (TKR)
Indications
Joint Pain (Uncontrolled)
Impaired Mobility
Considerations
Compression Dressing
Frequent Neurovascular Assessments
Continuous Passive Motion (CPM) Devices
Early Ambulation
Venous Thromboembolism (VTE) Prophylaxis
Limit Flexion Positions
Monitor for Infection
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2 mins
Rheumatoid Arthritis Assessment
Mechanism
Destruction of Connective Tissue and Synovial Membrane
Signs and Symptoms
Inflammation of Joints
Morning Stiffness
Nodules
Joint Deformities
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1 min
Rheumatoid Arthritis Interventions
Lifestyle Modifications
Heat and Cold Applications
Therapeutic Exercise
Balance Rest and Activity
Drug Therapy
NSAIDs
DMARDs
Glucocorticoids
Considerations
PT/OT
Reconstructive Joint Surgery
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2 mins
Cimetidine and Famotidine (H2 Receptor Blockers)
-tidine Suffix
Mechanism
H2 Receptor Blocker
Indications
Suppress Gastric Acid Secretion
Side Effects (All)
Pneumonia
Side Effects - Cimetidine
Anti-androgen Effects
CNS Changes
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2 mins
Methotrexate
Indications
Rheumatoid Arthritis
Cancer
Medical Abortion
Mechanism
Folic Acid Analog
Inhibits Dihydrofolate Reductase
Side Effects
Pulmonary Fibrosis
Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)
Macrocytic Anemia
Hepatitis
Teratogenic
Mucositis
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2 mins
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
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2 mins
Systemic Lupus Erythematosus (SLE) Assessment
Mechanism
Multisystem Inflammatory Disorder
Assessment
Malar Rash
Discoid Rash
Arrhythmias
Arthritis
Hemolytic Anemia
Seizures
Glomerulonephritis
Considerations
Periods of Exacerbation and Remission
Diagnosed by ANA (Anti-nuclear antibody assay)
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2 mins
Systemic Lupus Erythematosus (SLE) Interventions
Avoid Sunlight
Drug Therapy
Glucocorticoids
Methotrexate
NSAIDs
Hydroxychloroquine
Azathioprine
Considerations
Monitor for Renal Failure (ARF)
Manage Pain
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2 mins
Interventions for Impaired Skin Integrity
Assessment
Signs of Skin Breakdown
Pain
Redness
Decreased Skin Turgor
Bleeding
Bony Prominences
Intervention
Reposition Q2H
Pressure Relief
Maintain Clean and Dry Skin
Adequate Nutrition and Hydration
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2 mins
Gout Disease
Acute Inflammatory Monoarthritis
Epidemiology
Primarily in Males
Pathophysiology
Precipitation of Monosodium Urate Crystals
Underexcretion of Uric Acid
Overproduction of Uric Acid
Negatively Birefringent, Needle-Shaped
Symptoms
Swollen, Red, Painful Joint
Asymmetric Joint Distribution
Podagra
Tophus
After Large Meal or Alcohol
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2 mins
Gout Treatment
Acute (Acute-angle)
NSAIDs
Glucocorticoids
Colchicine
Impairs Leukocyte Chemotaxis
Chronic Gout (Crone Goat)
Inhibit Xanthine Oxidase
Allopurinol
Febuxostat
Inhibit Reabsorption of Uric Acid
Probenecid
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1 min
Lyme Disease
Mechanism
Transmitted by Ticks (Vector-borne)
Signs and Symptoms
Flu-like Symptoms
Bulls Eye Rash (Erythema Migrans)
Joint Pain and Stiffness
Facial Paralysis
Considerations
Antibiotics
Prevention
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2 mins
Tetracyclines Overview
End in "-cycline"
Mechanism of Action
Bacteriostatic
Indications
Infectious Diseases
Acne
Periodontal Disease
Nursing Considerations
Avoid Milk, Antacids, Iron
Sunlight Protection
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1 min
Cephalosporins
Starts with "Cef-"
Mechanism of Action
Bactericidal
Indications
Gram-Positive and Gram-Negative Infections
Side Effects
Allergic Reactions
Thrombophlebitis
Bleeding
Contraindications
Renal Impairment
Considerations
Avoid IV Calcium with Ceftriaxone
No Alcohol
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2 mins
Gabapentin
Primary Indication
Seizure Treatment
Secondary Indications
Peripheral Neuropathy
Postherpetic Neuralgia
Bipolar Disorder
Migraine Prophylaxis
Mechanism of Action
Inhibits Voltage-Gated Ca2+ channels
GABA Analog
Side Effects
Ataxia
Sedation
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1 min
Pregabalin (Lyrica)
Mechanism
GABA Analog
Indications
Seizures
Neuropathic Pain
Fibromyalgia
Side Effects
Headache
Dizziness
Somnolence (Fatigue)
Weight Gain
Angioedema
Rhabdomyolysis
Considerations
Dependence
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1 min
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
Indications
Depression
Diabetic Peripheral Neuropathy
Duloxetine
Panic and Anxiety
Venlafaxine
Mechanism of Action
Inhibits Reuptake of Serotonin and NE
Side Effects
Hypertension
Insomnia
Nausea and Vomiting
Decreased Libido
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1 min
Tricyclic Antidepressants (TCAs)
Mechanism of Action
Inhibits Reuptake of Norepinephrine and Serotonin
Indications
Depression
Bipolar Disorder
Fibromyalgia
Side Effects
Sedation
Orthostatic Hypotension
Anticholinergic Effects
Cardiac Toxicity
Considerations
Delayed Effect
Do Not Stop Abruptly
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2 mins
Tricyclic Antidepressants (TCAs) Indications
Indications
Major Depression
Bedwetting
Fibromyalgia
OCD
Drugs
-Iptyline or -Ipramine Suffix
Amitriptyline
Desipramine
Clomipramine
Imipramine
Nortriptyline
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2 mins

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