clothing with buttons or a zipper down the front instead of the back makes dressing easier. A cane or a walker offers support and relief of pain when walking. Ambulatory and Home care Heat and cold therapy: Heat and cold applications can help relieve stiffness, pain, and muscle spasm. Application of ice is especially beneficial during periods of disease exacerbation. Plastic bags of small frozen vegetables (peas or kernel corn), which can easily mold around the shoulder, wrists, or knees, are an effective home treatment. The patient can also use ice cubes or small paper cups of frozen water to massage areas proximal or distal to a painful joint. Application of moist heat appears to offer better relief of chronic stiffness than cold therapy. Superficial heat sources such as heating pads, moist hot packs, paraffin baths, and warm baths or showers can relieve stiffness to allow participation in therapeutic exercises. The heat application should not exceed 20 minutes at one time . Alert the patient to the possibility of a burn and the need to avoid the use of a heat-producing cream (e.g., capsaicin) with another external heat device. Can use as often as desired. However, the cold application should not exceed 10 to 15 minutes at one time. Ambulatory and Home care Exercise : Individualized exercise is an integral part of the treatment plan. • A therapeutic exercise program is usually developed by a physical therapist to include exercises that improve the flexibility and strength of the affected joints and the patient’s overall endurance. • Reinforce program participation and ensure correct performance of the exercises. • Inadequate joint movement can result in progressive joint immobility and muscle weakness, and overaggressive exercise can result in increased pain, inflammation, and joint damage. • Emphasize that participating in a recreational exercise program (e.g., walking, swimming) or performing usual daily activities does not eliminate the patient’s need for therapeutic exercise to maintain adequate joint motion. • Gentle ROM exercises are usually done daily to keep the joints functional. The patient should have the opportunity to practice the exercises with supervision. • Aquatic exercises in warm water (78° to 86° F [25° to 30° C]) allow easier joint movement because of the buoyancy and warmth of the water. At the same time, although movement seems easier, water provides two-way resistance that makes muscles work harder than they would on land. • During acute inflammation, exercise should be limited to one or two repetitions. Gout Gout is a metabolic disorder in which there is impaired purine metabolism. It is monoarticular without morning stiffness. The pain is considered mild. Know that they should avoid certain things in their diet and educate them on that. Have to know the risk factors and who develops gout. From lecture notes: Gout is the most common inflammatory arthritis. 3 million people report having it and men tend to have it more often than women. Primary gout is a hereditary error of purine metabolism which leads to overproduction or retention of uric acid (>7 mg/dL). This accounts for 90% of the cases.
You've reached the end of your free preview.
Want to read all 49 pages?
- Fall '16
- Denise Cauble
- Nursing, Wound infection