Osteoporosis and Osteoarthritis Case Studies

Osteoporosis and Osteoarthritis graphic symbol StudiesThe primary(prenominal) aim of this essay is to show different aspects of medical conditions ranging from pathophysiology, symptoms, hazard parts, and the attention of two case studies. The early case study deals with osteoporosis and osteoarthritis. The second case deals with peptic ulcers and gastric esophageal ebbing unhealthiness. To embrace both patients medical condition, knowing the conditions pathophysiology is quintessential.Osteoarthritis is a disease of the joins, which affects the slippery tissue called gristle which covers the joints (Kapoor, Martel-Pelletier, Lajeunesse, Pelletier Fahmi, 2010). The cartilage in healthy individuals ensures smooth sliding of grind aways over separately new(prenominal) and better shock absorbance. In osteoarthritic patients, wearing of the top grade of cartilage go aways to rubbing of rig divulges against one an different (Swift, 2012). This catchs firing off of the joint evident from swelling, unhinge and limited joint activity as clock time progresses (Kapoor et al, 2010). Excessive rubbing school principals to gradual decrease in bone wee with loss in shape, bone spurs growing at edges of joints and a to a greater extent anguishful condition manifested by floating of broken bones at joints in joint spaces (Swift, 2012).Osteoporosis on the other hand is marked by an im offset between bone resorption and bone formation do loss of skeletal mass (Huether McCance, 2012). In the normal physiological condition, bone resorption and formation are always in balance, thus maintaining the bone strength and mass. Any disorder in these two processes much(prenominal)(prenominal) as increased resorption or reduced formation can lead to osteoporosis (Huether McCance, 2012). In the above case Claire reported a fall and suffering which is a vulgar symptom in an osteoporosis case.The common modifiable risk component parts associated with osteopo rosis are vitamin D and calcium inadequacy (Wickham, 2011). Similarly cola, inebriant inlet and smoking are three modifiable factors which can increase the chances or insensibility of the disease. Excessive alcohol or cola drinks intake leads to secondhand osteoporosis by affecting bone formation, absorption of calcium and vitamin D, and disorder in calcium regulating hormone (Metcalfe, 2008). Estrogen deficiency can lead to post menopause condition where bone resorption is faster than bone formation (Marini Brandi, 2010). Lack of physical activity can make Claire disposed to osteoporosis (Metcalfe, 2008).Along with the above mentioned modifiable factors there are certain non-modifiable factors on which the control is less. Aging is the first factor which can lead to such disease (Barreiro, Acosta, Marquez, Rodriguez, Arriaga, 2013). In ageing, the supply of osteoblasts decreases against the demand of the body. Similarly genetic sensitivity and epigenetic are non-modifiable factors, the mothers health status during pregnancy, child drop got burden and weight at 1 year are prognosticative of bone mass till 70 years in womanish (Marini Brandi, 2010). The bone diseases like rheumatoid arthritis can withal leads to osteoporosis (Huether McCance, 2012).Experiencing distress may be the first factor Claire experiences with her osteoarthritis (Swift, 2012). The drying of synovial unstable leads to callousness of joints which may have been felt by Claire in her hip and knee joints (Swift, 2012). The constant presence of stiffness may lead to muscle weakness in that battleground. The weakening of muscles, drying of fluid, and inflammation combined effect may prune her movements such as bending, flexing and extending of joints (Goldring Otero, 2011).Osteoporosis often goes unnoticed until a fracture materializes (Brown, 2009). Claire was diagnosed with osteoporosis thus she may have experienced certain clinical manifestations which are common in osteoporosis. Since Claire has sustained fractures in her left colles and right shin bone/fibula she may experience acute suffering during movement of her work force and legs (Brown, 2009). The fractures she received referable to osteoporosis may limit her movement and affect the weight bearing capacity of her legs (Brown, 2009). With constant loss of bone at area of fractures, Claire may find it hard to jump erect and may stand in a stoop posture. Loss of height may occur due to increased bone loss (Brown, 2009).Post-operative nursing distinguishment of Claire involves a number of interventions to address the issues faced by Claire. In osteoarthritis and osteoporosis, the intimately common symptom experienced by patient is pain (Swift, 2012). Thus, the restrains interventions mustiness be to reduce the pain, by doing a pain assessment by means of a recommended scale. The pain must be mensural for areas moved(p), severity and Claires reporting of pain. The PRN medica l specialtys must be administered to Claire as per prescription and timing must be noted for each medication and dose (Colon, 2012). The imbibe should take care of any of Claires wounds through proper wound management interventions, in order to prevent inflammation and infection (Brown, 2009). Possibilities, of the fracture would mean Claire may stay in behind for a prolonged period, thus chances of having pressure ulcer increases. The same would assume for deep vein thrombosis which nurses can prevent by applying TED stockings (Brown, 2009). Nurses must transplant her position every 2 hours and a pillow can be provided at pressure areas to Claire. Nutrients, fluid and diet management should be on the watch with consultation with a dietician or a nutritionist (Brown, 2009). physical therapist interventions are required to assist her with walking and simultaneously the neurovascular assessment must be assessed by nurses to prevent neurovascular degeneration (colon, 2012).The imm ediate nursing interventions for Claire would be a primary assessment for immediate danger. The nurse should take a physical assessment on Claire, including assessing her airway patency and circulation. A pain assessment is essential as it provides the only way to ensure that management methods are appropriate and in force(p) (Elliott Coventry, 2012). The nurse should carry out a pain assessment on Claire using the PQRST model. This flake of pain assessment gives a detailed account of pain helping nurses to administer pain reduction medications keeping in mind the allergic reactions and six rights (Elliott Coventry, 2012). The nurse should document when analgesia was administered to Claire so other care team members will have a clear understanding of Claires pain (Brown, 2009). Claire must be assessed often for her presence of pain and she must be case-hardened straight off and effectively (Elliott Coventry, 2012).A number of factors play an important role in eliciting compli cations (early and later) post fracture cognitive operation. Complications which may be associated with Claires fracture operating theatre are during surgery the cutis and soft tissues are cut go across to reach to the bones, thus chances of bacterial infections exist which can lead to portentous situations if not prevented properly (Brown, 2009). both(prenominal) other serious complication of fracture is compartment syndrome where it causes decreased capillary perfusion below the level necessary for tissue viability (Brown, 2009). Presence of other co morbidities can prolong the recovery stage. Venous thrombosis can also lead to a complication after fracture (Brown, 2009). Precipitating factor is venous stasis which can be caused by incorrectly applied casts to Claire (Brown, 2009). Another contributing factor for the fracture complication on Claire if not treated properly would be flesh out embolism syndrome where presence of systemic fat globules is distributed into tissu es and organs after a traumatic skeletal injury (Brown, 2009).Case study 2Pathophysiology of gastro esophageal reflux disease is when the lower esophageal sphincter (LES) is attached to the leap out in the form of a plumb circuit (Huether McCance, 2012). Any structural changes occurring in between the stomach and esophageal barrier associated with abnormal relaxation of LES can lead to gastro esophageal reflux disease (Huether McCance, 2012).peptic ulcers occur with excess secretion of hydrochloric pane and pepsin, this impairs the balance between gastric luminal factors and the action of the gastric mucosal barrier, (Huether McCance, 2012). The main functions of gastric mucosal barrier are secretion of bicarbonate, defense of epithelial cells and mucosal simple eye flow. With increased secretion of acid, the mucosal barriers are affected and thus histamine is released. This activates the parietal cells to release more acids causing ulcers (Huether McCance, 2012).A clinical manifestation of peptic ulcers and gastro esophageal disease is heart burn, caused by acid reflux thus causing an inflamed esophagus (Huether McCance, 2012). Regurgitation occurs due to the loss of the mechanical barrier between the stomach and esophagus and is change by gastric acid reflux. Justin may experience upper abdominal pain within an hour of eating meals (Huether McCance, 2012). Due to excessive diarrhea, skin may get irritated, red and swollen. The stool with blood in it may be black and have an offensive smell due to oxidisation of hemoglobin (Huether McCance, 2012). The dysphagia experienced by Justin could be due intake of alcohol or acid containing nourishment which leads to esophageal spasms (Huether McCance, 2012). Due to excessive fluid loss, nurses may have noted that Justin presented as dehydrated.One common cause of Justins peptic ulcer could be his lifestyle of takeaway meals such as fried food, eating spicy and junk foods which has been hypothesized as a causal factor for ulceration (Huether McCance, 2012). Another major cause could be infection of the gastric and duodenal mucosa with Helicobacter pylori and regular use of non-steroidal anti-inflammatory drug drugs (NSAIDs), especially those that are classified as COX-1 inhibitors (Huether McCance, 2012). In Justins case, he has been buying over the counter medications for his chronic back pain which may increase the risk factor of gastric ulceration. The other associated factor would be alcohol consumption (Huether McCance, 2012). The medications commonly used to treat peptic ulcers are acid suppressors antacids such as ranitidine and famotidine they form a foam barrier between the stomach and esophagus thus preventing acid reflux (Brown, 2009). Similarly the H2 antagonists help in reducing the acid secretion in the stomach leaders to mend of ulcers (Brown, 2009). Proton pump inhibitors such as omeprazole are effective in decreasing acid secretion from the stomach. PPIs are used in conclave with antibiotics to treat ulcers caused by H. pylori (Brown, 2009).Bowel preparation is the artificial method of remotion of faeces from the colon in order to prepare Justin for any type of surgical physical process such as colonoscopy. The colons may have indigested food and fecal matters attached to them (Beck, 2010). The chances of infection increases if any surgical procedures are carried out nearby the colon area. Based upon Justins bowel movement patterns and stool characteristics he must be advised to go for a colon cleansing solution drink or laxative drink (Beck, 2010). This procedure can be done the day before scopes or some days before depending upon Justins condition. Enemas can also be administered found upon surgeons and specialists prescription. During the bowel preparation, nurses must keep in mind that Justins secrecy must be keep and hospitals policies and procedures are followed. documentation must be written in clear hand write for other t eam members to read about Justins treatment (Blair Smith, 2012).Peptic ulcers are characterized by tarry and bloody stools due to ulcerations in gastrointestinal tract. Excessive blood loss can be fatal for Justin leading to unconsciousness and other complications, thus it is advised for nurses to check the amount of blood and blood type (clots) (Brown, 2009). This can help to determine the severity of the disease and further diagnosis. The nurse should help Justin to return to his bed as arduous loss of blood leads to fluid deficiency and lowering of blood pressure. Justins vital signs must be assessed and fluids must be provided to manage the deficiency (Brown, 2009). While checking Justins abdomen for firmness, tenderness and pain, curtains must be pulled to keep Justins privacy. The findings must be documented and reported to the ward in charge doctor for further processing (Blair Smith, 2012).Post colonoscopy the nurse should manage Justins pain through an assessment of pai n, using a severity scale on a specified area and administering PRN medications (Brown, 2009). In order to recover from injury caused by his condition and address other complications associated with the disease, Justins nutritional status and fluid balance should be maintained (Brown, 2009). Due to heavy blood loss and pain, the patient may regain frustrated and anxiety symptoms may develop. The nurse should calm Justin, establish effective communication and allow him to express his feelings (Brown, 2009).In conclusion, the conditions such as osteoarthritis and osteoporosis can be disastrous to Claire as it can affect the fictitious character of her life to a high degree. The case remains the same for peptic ulcer and gastro oesophageal disease and can affect the eating habits of Justin. Thus, it is important to address both patients pain level and other complications in order for them to be comfortable. The disease process can be controlled through nursing interventions along wit h other medical interventions such as surgery and pharmacological management. It is essential for nurses to know pathophysiology of conditions of both cases described above in order to best manage both patients issues.