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Sample Class Presentation Using Concepts as Focus. Welcome! Please read the following pre-webinar notes:. Audio? Dial 1-877-783-2009 (Passcode: 936785) Attendees will be muted during the webinar until the Q&A session(s).

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Sample Class Presentation Using Concepts as Focus

Welcome! Please read the following pre-webinar notes:

Audio? Dial 1-877-783-2009 (Passcode: 936785)

Attendees will be muted during the webinar until the Q&A session(s).

Control Panel Large? Click the right arrow to hide the Control Panel.

Handout(s)? http://www.diassociates.com/media/webinars/Iggy_Webinar_120512.ppt

http://www.diassociates.com/media/webinars/Class_Objectives.doc

http://www.diassociates.com/media/webinars/Case_Study.doc

Need Help? Dial 1-877-341-4788 or Email [email protected]

Questions? Comments? Use the Chat pane or Email us at [email protected]

Contact Information? http://www.diassociates.com

[email protected]


Absence of conflict of interest
Absence of Conflict of Interest

As required by the American Nurses Credentialing Center’s Accreditation Program, we would like to make you aware of all potential conflicts of interests. This educational activity’s planners and the presenter have indicated they have no bias or conflict of interest. The host for this webinar is DI Associates, Inc. (owned by Donna Ignatavicius). Donna is also the speaker for this series of webinars. DB Productions is the provider for nursing contact hours for DI Associates and is owned by Deanne Blach. Both Donna and Deanne are nurse planners for the webinar.


Ancc disclosures
ANCC Disclosures

  • Off-label product usage – The speaker, Donna Ignatavicius, has attested that she will not discuss off-label usage of products.

  • Commercial support - There is no sponsorship (e.g. commercial support) for this activity.

  • Successful completion - Criteria for judging successful completion of the webinar are attendance at the entire activityand submission of a completed evaluation tool.

  • Expiration date - This workshop has been recognized for 1.25 contact hours and is valid for presentation for a period of two years beginning December 5, 2012.


Purpose of the Webinar

The purpose of each webinar is to assist faculty to design a class on arthritis using a concepts-based approach.

Objectives

The attendees will be able to:

  • Select appropriate concepts for exemplar health problem.

  • Explain how to use key concepts in sample class presentation.


Alterations in mobility care of adult patients with arthritis donna ignatavicius ms rn anef

Alterations in Mobility: Care of Adult Patients with Arthritis

Donna Ignatavicius, MS, RN, ANEF



What does a person with impaired mobility or immobility look like
What does a person with impaired mobility or immobility look like?



What is the nurse s role in preventing or managing impaired mobility
What is the Nurse’s Role in Preventing or Managing Impaired Mobility?

Think-pair-share

  • Write down your own answer to this question by making a list of nursing and ID interventions.

  • Share and compare your list with your partner.

  • What related curricular concepts did you identify in your shared list? (e.g., safety)


Terminology related to arthritis
Terminology related to Arthritis Impaired Mobility?

-- Arthritis = inflammation of joints

-- Synovitis = inflammation of synovium

-- Subluxation = partial joint dislocation

-- Connective tissue = tissue that connects and supports parts of the body


Osteoarthritis
Osteoarthritis Impaired Mobility?

  • Most common type of arthritis (local not systemic; degenerative joint disease)

  • Chronic joint pain, stiffness, and possible loss of function characterized by progressive deterioration and loss of cartilage in the joints (which joints most affected?)


Joint changes in osteoarthritis how would they affect mobility
Joint Changes in Impaired Mobility?Osteoarthritis: How Would They Affect Mobility?


Nursing assessment
Nursing Assessment Impaired Mobility?

  • History (risk factors???)

  • Physical assessment

    • Joint involvement (Which ones?)

    • Heberden's and Bouchard’s nodes (bony nodules at joints on fingers, especially women)

    • Joint effusions and inflammation(swelling)

    • Psychosocial assessment/Functional assessment


Other diagnostic assessment
Other Impaired Mobility?Diagnostic Assessment

  • Laboratory assessment of erythrocyte sedimentation rate (ESR) and C-reactive protein (may be slightly elevated)

  • Radiographic assessment

  • MR imaging (especially spine)


Priority for care managing chronic pain how do these interventions increase mobility
Priority for Care: Managing Chronic Impaired Mobility?Pain (How do these interventions increase mobility?)

  • Rest intermittent with exercise

  • Positioning (protect joints)

  • Heat/ice

  • Analgesics (NSAIDs)

  • Custom-made shoes


Priority for care managing chronic pain how do these interventions increase mobility1
Priority for Care: Managing Chronic Impaired Mobility?Pain (How do these interventions increase mobility?)

  • Weight control

  • PT/OT

  • Complementary and alternative therapies (e.g, acupuncture, glucosomine, chondroitin) (See Chart 20-2, p. 328)


Chronic pain surgical management last resort
Chronic Pain: Surgical Impaired Mobility?Management (Last Resort)

  • Total joint arthroplasty (TJA)/total joint replacement (TJR) (Who are candidates?)

    (minimally invasive surgery [MIS] or traditional)

  • Arthroscopy

  • Osteotomy/fusion (toes most often)


Test item check
Test Item Check Impaired Mobility?

Which assessment findings would the nurse expect for a client diagnosed with late osteoarthritis? Select All That Apply.

  • Painful joints

  • Skin rash

  • Subcutaneous nodules

  • Decreased mobility

  • Bony joint nodes


Rheumatoid arthritis
Rheumatoid Arthritis Impaired Mobility?

  • One of the most common connective tissue diseases and the most destructive to the joints!

  • Chronic, progressive, systemic inflammatory autoimmune disease affecting primarily the synovial joints (remissions and exacerbations)

  • Autoantibodies (rheumatoid factors) form that attack healthy tissue, especially synovium, causing inflammation


Nursing assessment1
Nursing Assessment Impaired Mobility?

VENN diagram to compare and contrast OA and RA assessment findings

(Pair activity)


Other assessment
Other Assessment Impaired Mobility?

  • Imaging tests, including x-ray

  • Laboratory Assessment:

    • ESR (erythrocyte sedimentation rate, or “sed” rate)

    • RF (rheumatoid factor)

    • ANA (anti-nuclear antibody)


Early ra of hands
Early RA of hands Impaired Mobility?


Advanced ra joint involvement
Advanced RA Joint Involvement Impaired Mobility?


Examples of late ra complications
Examples of Late RA Complications Impaired Mobility?

  • Subcutaneous nodules


Examples of late ra complications1
Examples of Late RA Complications Impaired Mobility?

  • Vasculitis

  • Anemia

  • Major organ involvement

  • Sjogren’s syndrome (sicca syndrome)


What are the most common priority problems for patients with ra and how are they managed
What are the Most Common Priority Problems for Patients with RA and How Are They Managed?

  • Chronic Pain

  • Decreased Mobility

  • Stress response



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