Signs and Symptoms of ACute Gouty Arthritis including the

Treatment

- it is SYSTEMIC
- it is due to increased uric acid serum level (causes gout) or deposition of urate
crystals in joints and other body tissues
- Due to a disorder of purine metabolism, excess uric acid in blood (Uric acid is the
end product of purine diet).
- Gouty Arthritis is also caused by hyperuricemia (increase uric acid in the blood).

Nursing Goal of Gouty Arthritis

• to relieve pain
• to protect affected part

Overview and Osteoarthritis Symptoms

Osteoarthritis

• Due to wear and tear of the cartilage caused by overused joints

• Mostly affected are the weight-bearing joints (knees, hip, and lower spine). This
joints are inflamed
• Formation of bony buildup and loss of articular cartilage causing crepitus
• degenerative joint disease (hips and knees).

Causes of Osteoarthritis
• Idiopathic
• excessive use of a specific joints
• repeated joint injury
• old age and obesity

Osteoarthritis Symptoms and Signs

• limited ROM
• pain in motion
• compression of the spine as manifested by pain
• pain increases with activity
• joint stiffness and immobility
• muscle spasms
• skeletal muscle atrophy
• Heberdens Nodes - bony nodules on distal finger joints
• Bouchard's Node

Diagnosis of Osteoarthritis - X-ray

Treatment of Osteoarthritis

• Analgesics
• rest (best management)
• hot moist pack
• Paraffin wax (brushing technique)

Nursing Goals of Osteoarthritis

• to relieve pain
• to prevent further stress of joints (plan ADL or activity of daily living)
• to maintain regular exercise

AIDS Research (Acquired Immune Deficiency Syndrome)

AIDS research (Acquired Immune Deficiency Syndrome) Overview

• Caused by human immunodeficiency virus

• When the T4/CD4 cell count falls below 200/mL opportunistic infections are
greatest because the immune system is severely depressed
• Incubation Period estimates range from ½ to 10 years and may be longer
• The antibodies produced by the body are generally first be detected in the blood in
2 weeks to 3 months or longer after infection

AIDS Clinical Findings

1. Subjective:
– Anorexia, fatigue, dyspnea, chills, sore throat

2. Objective:

– Positive for HIV antibody: ELISA and Western Blot

– Positive for HIV itself: Polymerase chain reaction
– Decreased CD4/T4 cells
– Night sweats
– Enlarged lymph nodes
– Wasting syndrome: wt loss exceeding 10% baseline weight, chronic diarrhea for
more than 30 days, chronic weakness and constant fever
– HIV encephalopathy: memory loss, lack of coordination, partial paralysis, mental
deterioration

HIV is present in…

• Blood
• Semen
• Vaginal secretions
• Blood-tinged saliva
• Tears
• Breast milk
• CSF
• The virus is not viable outside the body

AIDS: Classification System

• T4/CD4 categories

1. Category 1: less than or equal to 500 cells /mL

2. Category 2: 200 to 499 cells/ mL
3. Category 3: less than 200 cells/ mL

• Clinical Categories

1. Category A: asymptomatic HIV

2. Category B: presence of opportunistic infection/s
3. Category C: presence of all opportunistic conditions

AIDS OPPORTUNISTIC INFECTIONS

1. Protozoal:
– PCP, toxoplasmosis

2. Fungal:
– Candidiasis, histoplasmosis
3. Bacterial:
– Mycobacterium avium-intracellulare complex
–Mycobacterium tuberculosis

4. Viral:
– Herpes, varicella-zoster, cytomegalovirus

5. Malignancies:
–Kaposi’s sarcoma, B-cell lymphomas, non-Hodgkin’s lymphoma

AIDS: Therapeutic Interventions

– No cure, prevention is the key

– For PCP: trimethorprim sulfamethoxazole (Bactrim), pentamide
– For TB: isoniazid, rifampin, ethambutol
– For Fungal infections: nystatin, amphotericin B, ketoconazole