Mental Health

Mental Health

1. Osteoarthritis

   • Pathophysiology
     • Osteoarthritis is caused by the biochemical breakdown of articular cartilage in the synovial joints and the entire joint organ, including the subchondral bone and synovian.
   • Cause
     • Lose of balance between cartilage breakdown and production, degeneration exceeds regeneration
     • Deterioration of the articular cartilage
     • Increase the development
       • Obesity, misalignment of bones and joints, joint trauma and injury, exercise
   • Risk factors and signs/symptoms
     • Over the age of 45, more common in women
       • Pain, stiffness, swelling, harry potter wand fingers,
   • Treatment and Management
     • Pain management with NSAIDS
       • Non-pharm: physio, OT, exercise, acupuncture and nutritional supplements
         • Pharm: paracetamol, NSAIDS, capsaican, analgesics, hormone replacement therapyy
   • Nursing interventions
     • Promote self-management through health education
       • Assessments should include function, mood, mobility and pain assessments

2. Gout

   • Pathophysiology
     • An inflammatory reaction to monosodium urate crystals.
       • Increased production of uric acid, decreased excretion, increased purine intake - increase urate levels
         • Needle-shaped monosodium urate crystals which are deposited in the articular cartilage or in the tend sheaths, ligaments and around distal joints and tissues.
   • Risk factors and signs/symptoms
     • Acute and come out of nowhere. Severe pain in the joints, nodules on joints - redness and inflammation, tender and hot joints. Often onset of pain at night.
   • Causes
     • Hyperuricemia > 6.8. Crystals in the joints bruv.
   • Treatment and Management
     • Pharm - rate lowering treatment for recurrent attacks
       • Allopurinol
         • Used to decrease uric acid concentrations. Taken once daily after meal. SIDE EFFECTS: skin reactions, headaches.
       • Probenecid
     • Pharm - acute gout:
       • Colchicine
         • Inhibits urate crystal deposition. Not an analgesic but relies pain in acute attacks of gout. You can't take it if you have kidney and liver disease, cardiac or GI disorders.
       • NSAIDS; diclofenac, ibuprofen
   • Nursing Interventions
     • Health education
       • Keep a healthy body weight, rest lots, keep sheets off of the joint if its an early morning attack. Drink 2L of water.
       • Avoid purine rich foods: red meat, fish, yeast extracts. Avoid alcohol and soft drinks.

3. Rheumatoid Arthritis

   • What is it
     • Chronic disease that cannot be cured. Form of inflammatory arthritis and autoimmune diseases. Fluid build up causing inflammation and joint pain, systemic and intermittent. Is the second most common form of arthritis and women are three times more likely to develop RA than men.
   • Signs and symptoms
     • Fatigue, pain in the joints, swelling of the joints, stiffness in the joints, muscle pain
   • Treatment and Management
     • Treats the symptoms. Reducing pain and inflammation, minimising or preventing joint damage and maximising join movement.
   • Interventions
     • Education and counselling. Self-management support approach. Information and referral to support networks. Fatigue management and exercise. Encouraing reg check ups

4. Neurotransmitters

   • GABA