A nurse is caring for a 78-year-old patient with a history of osteoarthritis. When doing the initial assessment the nurse knows that he will most probably find what signs and symptoms?
A) Joint pain, crepitus, Heberden's nodes
B) Hot, inflamed joints; crepitus; joint pain
C) Tophi, enlarged joints, Bouchard's nodes
D) Swelling, joint pain, tenderness on palpation
Ans: A
Feedback: The primary clinical manifestations of OA are pain, stiffness, and functional impairment. The pain is caused by an inflamed synovium, stretching of the joint capsule or ligaments, irritation of nerve endings in the periosteum over osteophytes (bone spurs), trabecular microfracture, intraosseous hypertension, bursitis, tendinitis, and muscle spasm. Stiffness, which is most commonly experienced in the morning or after awakening, usually lasts less than 30 minutes and decreases with movement. Functional impairment results from pain on movement and limited motion caused by structural changes in the joints. The joint pain occurs with movement and is relieved by rest. As the disease progresses, pain may also occur at rest. Heberden's nodes are bony growths that occur at the distal interphalangeal joints. Bouchard's nodes involve the proximal interphalangeal joints. Tophi are deposits of sodium urate crystals that occur in chronic gout, not osteoarthritis. Hot, inflamed joints rarely occur in osteoarthritis. Swelling, joint pain, and tenderness on palpation occur with a sprain injury.
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