Arthritis are part of the broader category of rheumatic diseases, although the two terms are often used interchangeably. Some rheumatic diseases can also affect internal organs and tissues of the body.These diseases are in first place in both the U.S. and Europe as a cause of disability in the population, especially in older women.

Until recently, arthritis was confused and also associated with arthritis, but that is a very different disease that affects the chondrocytes, the cells constituting the cartilage and that, despite having an inflammatory component is not an inflammatory disease.

The various forms of arthritis are now a huge public health problem is the high impact on the population for treatment costs and benefits associated with them, given the incapacity to work and perform the daily tasks of those affected. Usually, these are chronic conditions, which can then accompany the victim from the moment they appear for the rest of his life.

Disease, many forms

Among the various forms of arthritis, the most common are:

Osteoarthritis is the most common among older people and is the leading cause of physical disability, especially among women after 45 years of age.Cartilage lesions and consequently often involves direct contact between the bones in the joints. It occurs on hands, neck, lower back and joints where you download the weight of the body such as knees, hips and feet.

Rheumatoid arthritis affects the joints but also the skin tissues, lung, eye and blood vessels.Affected people feel tired and sometimes feverish.Rheumatoid arthritis is an autoimmune disease that usually occurs in a symmetrical manner in various organs (both hands or both knees).Can appear at any age but usually affects people in their period of greatest productivity.Women are affected about twice as many men.

Gout: manifests as sudden and intense pain and inflammation and swelling of the joints.Often the attacks are nocturnal and may be arising from use of alcohol, drugs or other pre-existing diseases.Due to the accumulation of uric acid crystals in connective tissue found in joints.It ‘s more common in men between 40 and 50 years, while women usually appears only in menopause.

Juvenile rheumatoid arthritis: the most common form in children, which causes pain, stiffness, swelling and loss of function of the joints.May be associated with episodes of fever and can affect various parts of the body.

Fibromyalgia: a chronic disease cause pain in all the tissues that support the bones and joints.The pain and stiffness occur in the muscles and tendons, especially on the neck, spine, shoulders and hips.

Systemic lupus erythematosus: an autoimmune disease that involves inflammation of joints, skin, kidneys, heart, lungs, blood vessels and brain.In addition there are other forms of arthritis, which also affect internal organs and tissues.

The symptoms of the disease occur at several levels:

Treatment

It is worthwhile to reiterate that there is today, except in the case of infectious arthritis, no curative treatment of the disease.Instead, they can apply a range of therapies aimed at improving the lifestyle of the patient, reducing pain and disability and thus restoring the ability to perform daily tasks and possibly work activities.

Among the most effective forms of treatment, including periods of rest and relaxation and adequate physical activity. This last point is particularly critical because the person with arthritis may have a tendency to a certain lack of exercise, thus contributing to an aggravation of their clinical on other fronts, such as tending to gain weight until you reach situations of overweight or obesity, which end up further exacerbate the development of arthritis.Treatment is then based on a proper diet, eg low-purine in the case of gout, and use of specific drugs like Glucosamine .Given the chronic nature of disease, medications are only at alleviating symptoms.However, there is a wide range of pharmacological products specific to different types of arthritis and proper treatment should be chosen based on the results of diagnosis and identification of arthritis developed by that patient.

Even the hot and cold therapy can reduce pain and inflammation of arthritic.In the first case, apply poultices and massage spray cooling and run directly on the ice in pain for the purpose of cooling reduces the sensitivity of the nerves present.In the second case, using wax, microwave, ultrasonic and steam to increase blood flow and increase pain tolerance, and flexibility. Choosing the most appropriate therapy depends on the type of arthritis diagnosed.

In some cases aids are proposed for reducing the pain and move better. Especially in the home is important to promote the use of supports and aids that will avoid the risk of falls, for example in the shower or bathroom.

In severe cases it is possible to resort to surgery to replace joints.

COMMENTS:
• Conform to the schedule change of position (usually every 4 / 6 h) respecting the hours of sleep.
• Maintain roads with extreme caution, cannulas, polls and oxygen therapy in the event that had it, to avoid strains and avulsions.
• Comply with the technique of execution.
• Consider diagnosis and pathology of the patient to avoid positions that might be harmful.
• In some cases, the change can facilitate postural drainage of respiratory secretions.
• Staff operating the postural change, must acquire a sound position to avoid back injuries, flexing your knees apart, keeping your back as straight as possible and the body as close as possible to bed to make the slightest exertion.
RECORDS:
• Record on the sheet of nursing time of change and the position taken in the same.
• Note if there has been any incident or has any red area appeared capable of UPP

Geriatric syndrome.
• Fall
• Urinary incontinence
• Immobility
• Infectious process
• Delirium
• Oral diseases
• Food and nutrition
• Dementias
• Depresion.Síndrome restraints.


Decline in ability to perform activities of daily living impairment or deterioration of motor functions.
Can be avoided, even during a serious illness.
-> 65 years 18% problems with mobility without assistance
-> 75 years 50% difficulty in emerging
20% confined to home.

Rating:
Acute:
3 days patients spend in bed or chair. 33% of fixed assets are causes of death after three months and 58% a year.
Etiology of immobilization.
• Pain and stiffness
• Cause cardiovascular and pulmonary
• Neurological causes
• General weakness
• Metabolic causes
• Mental Illness
• Custom
• Lack of support (without a walker, cane or burrito)
• Impaired vision and hearing
• Instability and fear of falling
• urinary and fecal incontinence
• Iatrogenic (drugs, immobilization)
• Architectural Barriers
• Disease of the feet.

Complications.

• Thrombosis
• Thromboembolism
• Pneumonia
• Dehydration
• Malnutrition
• Osteoporosis
• Hypothermia
• Confusion
• Depression
• Withdrawal and isolation
• UPP
• Stiffness and contractures
• Loss of muscle strength
• Constipation and implementation
• Retention and incontinence
• Instability and Falls

Muscle shortening and retraction. These can be avoided by the early installation of exercises to maintain or improve joint mobility ranges. Change the immobile patient from his bed to a chair is not enough, for it can produce shortening of the hamstrings at 90 degrees or more of knees exercises you need to add legs and general exercises in bed progressively.

Venous thrombosis. Of particular interest, for the high morbidity and mortality it entails. The presence of deep vein thrombosis and pulmonary embolism can occur in patients by just being still and a much greater extent in those with congenital factors determining factors for these diseases (activated protein C deficiency by mutation of Factor V Leiden mutation 20,210 of the prothrombin gene, deficiency of protein C and S deficiency, antithrombin III, etc.). Measures to avoid these complications, along with exercise, are the use of prophylactic heparin, either unfractionated or low molecular weight or intermittent lower limb bandage.

Urinary and fecal incontinence. Often these patients suffer fecal incontinence secondary to fecal impaction with pseudodiarrea then Fecaloma urinary incontinence. Therefore, digital rectal examination should be performed against the suspect in this table and managed a diet rich in fiber, rich fluid and prokinéticos use, to prevent the occurrence of constipation and its consequences.