SPURTY COLLEGE OF NURSING

SUBJECT: Medical Surgical Nursing

ASSIGNMENT ON
ARTHIRITIS

SUBMITTED TO:

SUBMITTED BY:
Umar Firdous
M.Sc. Nursing 1st year

SUBMITTED ON:
 Introduction
Arthritis is a general term for conditions that affect the joints, causing
inflammation, pain, stiffness, and swelling. It can impair joint function and
significantly affect a person's quality of life. There are over 100 types of
arthritis, with Osteoarthritis (OA) and Rheumatoid Arthritis (RA) being the
most common. The causes of arthritis can vary, ranging from wear and tear on
the joints to immune system dysfunctions.

Types of Arthritis
1. Osteoarthritis (OA):

Cause: Wear and tear on the joints due to aging, injury, or overuse.

Symptoms: Joint pain, stiffness, decreased range of motion, and swelling.

2. Rheumatoid Arthritis (RA):

Cause: Autoimmune reaction that leads to chronic inflammation in the joints.

Symptoms: Pain, swelling, stiffness, and possible joint deformity, often

involving small joints such as the fingers, wrists, and toes.

3. Gout:

Cause: High levels of uric acid due to diet (high in purines) or impaired kidney
function.

Symptoms: Intense pain, swelling, and redness in a single joint (often the big
toe).

4. Psoriatic Arthritis:

Cause: Autoimmune response affecting the joints and skin.

Symptoms: Joint pain and swelling, skin rashes, and nail changes.

5. Ankylosing Spondylitis:

Cause: Autoimmune disorder that affects the spine and sacroiliac joints.
Symptoms: Pain and stiffness in the lower back, hip pain, and difficulty bending
the spine.

Aetiology and Risk Factors

Genetic Factors: Family history of arthritis, especially in RA and OA.

Age: Risk increases with age, particularly for OA, while RA can affect
individuals at any age.

Gender: RA is more common in women, while OA affects both men and

women, with men being more affected at an earlier age.

Obesity: Overweight individuals are more prone to OA due to increased joint

stress.

Trauma: Previous joint injuries increase the risk of developing arthritis.

Infections and Immune Dysfunction: In conditions like RA and psoriatic

arthritis, infections or an immune system malfunction lead to inflammation and
joint damage.

Pathophysiology
1. Osteoarthritis (OA):

The degeneration of articular cartilage leads to joint instability and pain. This
occurs due to wear and tear, aging, or injury. The cartilage breaks down, and
bone spurs (osteophytes) may form at the joint margins, causing pain and
stiffness

2. Rheumatoid Arthritis (RA):

RA is characterized by the immune system attacking the synovium. The

inflammation results in the thickening of the synovium and progressive damage
to the cartilage and bones, causing deformities and joint destruction.
3. Gout:

High levels of uric acid cause crystals to form in the joints, leading to intense
inflammatory reactions. The inflammatory response can lead to joint pain,
swelling, and potential permanent joint damage if untreated.

Clinical Manifestations

1. Osteoarthritis (OA):

Pain: Especially after activity or long periods of immobility.

Stiffness: Typically worse after rest or in the morning.

Swelling: Mild, localized to the affected joints.

Limited Range of Motion: Difficulty bending or moving the joint.

2. Rheumatoid Arthritis (RA):

Pain and Swelling: Symmetrical joint involvement, often starting in smaller

joints like the fingers and wrists.

Morning Stiffness: Lasting for more than an hour.

Fatigue: Due to systemic inflammation.

Deformity: If untreated, joints may become deformed.

3. Gout:

Sudden Severe Pain: Often in the big toe or other small joints.

Redness and Swelling: Affected joints become red, swollen, and hot to the
touch.
Recurring Attacks: Acute flare-ups of symptoms.

4. Psoriatic Arthritis:

Joint Pain and Swelling: Can affect any joint, but often involves fingers, toes,
and the spine.

Skin Rash: Psoriasis patches on the skin often accompany the joint symptoms.

Nail Changes: Pitting and discoloration of nails.

Diagnosis
1. Medical History: Detailed history of symptoms, family history, and risk
factors.

2. Physical Examination: Includes inspection and palpation of joints, assessing

for warmth, swelling, and tenderness.

3. Laboratory Tests:

Rheumatoid Factor (RF) and Anti-CCP Antibodies for RA.

Uric Acid Levels for gout.

Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) for

inflammation.

4. Imaging:

X-rays: To assess joint damage and deformities (especially in OA and RA).

Ultrasound: Can detect inflammation and joint effusions.

MRI: To evaluate soft tissue damage and joint involvement, particularly in RA.

Treatment
1. Pharmacological Treatments:
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): For pain and
inflammation control.

Disease-Modifying Antirheumatic Drugs (DMARDs): For RA (e.g.,

methotrexate).

Corticosteroids: For inflammation reduction.

Biologics: Target specific immune system components in RA and psoriatic

arthritis.

Colchicine and Urate-Lowering Therapy for gout.

2. Non-Pharmacological Treatments:

Physical Therapy: Helps to maintain joint function and reduce stiffness.

Exercise: Low-impact activities (e.g., swimming, walking) can improve joint

mobility and reduce pain.

Joint Protection: Use of assistive devices (e.g., splints, canes) to reduce joint
stress.

Heat and Cold Therapy: To relieve pain and inflammation.

3. Surgical Treatments:

Joint Replacement Surgery (e.g., hip or knee replacement) for advanced OA.

Arthroscopy: For cleaning up joints in OA or repairing damaged tissue.

Nursing Care

1. Assessment:

Regular monitoring of joint pain, range of motion, and functional ability.

Assessment for complications such as joint deformities, functional impairment,
or adverse effects of medications.

2. Pain Management:

Administer prescribed medications (e.g., NSAIDs, DMARDs) and monitor for

side effects.

Apply non-pharmacological interventions like heat/cold therapy, positioning,

and relaxation techniques.

3. Education:

Educate patients on medication adherence, proper joint protection techniques,

and the importance of regular physical activity.

Advise on dietary modifications (e.g., avoiding purine-rich foods in gout) and

weight management.

4. Support:

Provide emotional support and resources, as chronic arthritis can affect mental
well-being.

Encourage participation in support groups to cope with the challenges of living

with arthritis.

Conclusion

Arthritis is a broad condition that encompasses various forms of joint

inflammation and damage. The management of arthritis requires a combination
of pharmacological treatment, lifestyle modifications, physical therapy, and in
some cases, surgical intervention. Nurses play an essential role in the care of
patients with arthritis, from assessment and pain management to education and
support, ensuring improved quality of life for those affected by the condition.

References

1. National Institute of Arthritis and Musculoskeletal and Skin Diseases

(NIAMS). (2022). What Is Arthritis?. Retrieved from
https://www.niams.nih.gov/health-topics/arthritis

2. Mayo Clinic. (2023). Arthritis: Symptoms and Causes. Retrieved from

https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-
20350703