1. General information
    1. Chronic, nonsystemic disorder of joints characterized by degeneration of articular cartilage
    2. Women and men affected equally; incidence increases with age
    3. Cause unknown; most important factor in development is aging (wear and tear on joints); others include obesity, joint trauma
    4. Weight-bearing joints (spine, knees, hips) and terminal interphalangeal joints of fingers most commonly affected
  2. Assessment findings
    1. Pain (aggravated by use and relieved by rest) and stiffness of joints
    2. Heberden's nodes: bony overgrowths at terminal interphalangeal joints
    3. Decreased ROM, possible crepitation (grating sound when moving joint)
    4. Diagnostic tests
      1. X-rays show joint deformity as disease progresses
      2. ESR may be slightly elevated when disease is inflammatory
  3. Nursing interventions
    1. Assess joints for pain and ROM.
    2. Relieve strain and prevent further trauma to joints.
      1. Encourage rest periods throughout day.
      2. Use cane or walker when indicated.
      3. Ensure proper posture and body mechanics.
      4. Promote weight reduction if obese.
      5. Avoid excessive weight-bearing activities and continuous standing.
    3. Maintain joint mobility and muscle strength.
      1. Provide ROM and isometric exercises.
      2. Ensure proper body alignment.
      3. Change client's position frequently.
    4. Promote comfort/relief of pain.
      1. Administer medications as ordered: aspirin and NSAIDs most commonly used; intra-articular injections of corticosteroids relieve pain and improve mobility.
      2. Apply heat as ordered (e.g., warm baths, compresses, hot packs) or ice to reduce pain.
    5. Prepare client for joint replacement surgery if necessary.
    6. Provide client teaching and discharge planning concerning
      1. Use of prescribed medications and side effects
      2. Importance of rest periods
      3. Measures to relieve strain on joints
      4. ROM and isometric exercises
      5. Maintenance of a well-balanced diet
      6. Use of heat/ice as ordered