NSG 500 - Advanced Health Assessment
Exam 3
Question:
Osteoarthritis
Answer:
Onset: insidious, over many years
Morning stiffness: few minutes, localized joints
Pain: on motion, prolonged activity, relieved with rest
Weakness: usually localized, not severe
Fatigue: unusual
Depression/lability: unusual
Tenderness: common
Swelling: noninflammatory effusion common, little synovial reaction
Heat/erythema: unusual, minimal if present
Crepitus: coarse to medium on motion
Joint enlargement: mild with bony consistency due to osteophytes
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Question:
Rheumatoid
Answer:
Onset: gradual (weeks to months) or sudden (24-48 hours)
Morning stiffness: several hours
Pain: even at rest, may disturb sleep
Weakness: often pronounced, out of proportion with muscle atrophy
Fatigue: often severe, onset 4-5 hours after rising
Depression/lability: common, coinciding with fatigue and disease activity,
often relieved if in remission
Tenderness: almost always, most sensitive indicator of inflammation
Swelling: fusiform soft tissue enlargement, inflammatory effusion common,
synovial proliferation and thickening, symmetric, rheumatoid nodules
Heat/erythema: Sometimes present
Crepitus: medium to fine
Joint enlargement: moderate to severe if an inflammatory effusion is present
Question:
RA subjective/objective
Answer:
-joint pain/stillness especially in morning
-constitutional symptoms: fatigue, myalgia, weight loss, low grade fever
-cause unknown
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Question:
how to identify scoliosis
Answer:
-lateral curvature or rib hump during flexion to touch toes -uneven shoulder and hip levels; may have crease on one side at the waist -looks like an s or c
Question:
gout
Answer:
-onset of hot/swollen joint, exquisite pain, limited ROM -primarily affects men over 40, postmenopausal women -usually the proximal phalanx of the great toe, can also be in wrists, hands, ankles, knees -skin over joint appears shiny/red/purple -uric acid crystals form as tophi under skin with chronic gout
Question:
OA: onset/subjective
Answer:
-onset after 40 years, 100% after 75 years old -many have enlarged joints due to bone growths (osteophytes)
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