A nurse is caring for an old lady with osteoarthritis and all the following facts are true regarding osteoarthritis EXCEPT

Appeared in: JIPMER Nursing Officer-2017

Explanation

Tophi are hard deposits of uric acid crystals that form under the skin in and around joints.
They are a specific and defining feature of chronic gout, a type of inflammatory arthritis caused by hyperuricemia.
Osteoarthritis is a degenerative disease related to cartilage breakdown and does not involve the deposition of uric acid crystals.

Option A: Crepitus, a grating or crackling sensation in the joint, is a classic clinical sign of osteoarthritis. It results from the loss of smooth articular cartilage, causing rough bone surfaces to rub against each other during movement.
Option C: The term 'subcutaneous nodules' in rheumatology typically refers to the soft, non-tender nodules found in patients with Rheumatoid Arthritis (RA). Osteoarthritis is characterized by hard, bony enlargements called Heberden's and Bouchard's nodes, which are osteophytes, not soft tissue nodules.
Option D: Pain that worsens with joint movement or activity and is relieved by rest is the most common and characteristic symptom of osteoarthritis. It is directly related to the mechanical stress on the damaged joint.

Clinical Relevance

Nursing practice connection: Knowing Clinical manifestations of Osteoarthritis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Differentiating between types of arthritis is crucial for providing appropriate nursing care, patient education, and medication administration.
For example, management for OA focuses on pain relief and lifestyle modification (weight loss, exercise), while gout requires medication to lower uric acid levels, and RA requires immunosuppressive drugs.
A nurse's accurate assessment helps in early identification of the correct condition, leading to better patient outcomes and prevention of joint damage.

How to Approach the Question

First, identify the core subject of the question, which is 'osteoarthritis'.
Next, notice the keyword 'EXCEPT'. This means you are looking for the option that is FALSE or not associated with osteoarthritis.
Evaluate each option against your knowledge of osteoarthritis:
Is crepitus a sign of OA? Yes.
Is pain on movement a sign of OA? Yes.
Are tophi a sign of OA? No, they are a sign of gout.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 109-111

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1197-1199

E6 Medicine Davidson Principles Practice 24e p. 1029-1031

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