Case study of patient with Osteo-Arthritis | Report

2/20/2020
unning eadR H : OA 0
Case stud of atient it teo rt ritisy p w h O -A h
ssaE y
tudent na eS m

OA 1
Table of Contents
Introduction...........................................................................................................................................2
Health issue.......................................................................................................................................2
Management......................................................................................................................................3
Assessment and services....................................................................................................................4
Communication.................................................................................................................................6
Conclusion.............................................................................................................................................6
References.............................................................................................................................................9

OA 2
Introduction
Osteoarthritis is the problem joints which commonly affect old individual and
recognized as the most common type of arthritis. It has been reported that around 30 million
individuals are affected by this health issue in the United States. it is recognized as the
degenerative disorder that occurred form the biochemical disruption of articular cartilage in
the human synovial joints. Osteoarthritis is sometimes termed as wear and tear arthritis. This
particular health issue mostly affects joints and occurs in hands, knees, hips, neck and lower
back. The symptoms of the disorder start gradually and deteriorate over time (Kloppenburg &
Berenbaum, 2020). This particular report will discuss the health issue in Australia,
medication management, assessment, and information required for the patient.
Health issue
Osteoarthritis is not restricted to a particular city or nation; it has been affecting
people from all around the world. Particularly in Australia, one in eleven Australian has this
problem. According to a report published in the Australian Bureau of Statistics (2019), an
estimated 924,000 (3.8 per cent) people are diagnosed with osteoarthritis in Australia in
2017-2018. Females are more likely to be affected by this health issue and three in five
Australian who have OA are female. There is 38 percent of the rise in the total knee
replacement surgeries has been noticed between 2005-06 to 2016-17.
OA is mostly associated with age. With the aging process, the water content in the
cartilages upsurges and there is degeneration in protein make-up cartilage takes place.
Recurrent use or movement of joints over time causes impairment to the cartilage that results
in joint pain and inflammation (Brembo et al., 2016). Ultimately, the cartilage starts
degenerate through flaking or developing small creases. In advance stages, there is a
complete loss of the body's cartilage cushion, present between the bone of the knee or hand

OA 3
joints (Chen et al., 2017). The impairment of the cartilage cushion triggers a friction between
the bones, resulting in pain and limitation of the joint mobility (Jaswal et al., 2017).
Impacts of these health issues can be associated with both physical and mental health.
OA can have a profound impact on a patient's life. Some of the symptoms associated with
OA include pain, stiffness of joints, tenderness, loss of flexibility, grating sensation, bone
spurs, and swelling (Chen et al., 2017). OA does not only affect the persons with the disease
but also affects their family members as they have to assist them continuously and pay
medical bills. This might be a stress full event for both the patient and his loved ones. The
pain and physical restriction and associated stress and depression can cause social isolation
and his or her ability to involve in the community and occupational activities. As Jack avoid
going outside his room and attend medical appointments, it is clear that he has developed
depression (Parkinson et al., 2017).
Management
Mr. Di Lorenzo has been taking some complementary medicine that might be
affecting his health. Some of them are glucosamine, fish oil, and willow bark. Fish oil is
generally provided in osteoporosis as an additional drug. It has been provided to jack without
the guidance of the doctor. It can interact with drugs like anticoagulants and antiplatelet
drugs, blood pressure drugs, orlistat, and vitamin E (Evaniew & Evaniew, 2017). The risk of
bleeding is also increase when it is provided in combination with medication like aspirin.
Some of the side effects that may be raised include rare bleeding or staining, faintness,
dizziness, tarry stools nausea, rashes, indigestion, bad breath, and a fishy aftertaste. The
patient may also experience a cough or vomit fresh or dried coffee grounds like blood,
headache; and faintness (Hill et al., 2016). Glucosamine sulfate can source some mild
negative effects counting nausea, indigestion, diarrhea, and constipation. Uncommon side
effects are drowsiness, skin reactions, and headache (Nakamura, 2011). As Mr. Di Lorenzo is

OA 4
also provided with willow bark accompanied by aspirin by his family members, it might upsurge
the adverse reaction of aspirin-like stomach aches, and problems to the gastrointestinal system
(Shara & Stohs, 2015). The diseased person may also develop symptoms like itching, rashes on
the skin, and different types of allergies. This specific medicine can worsen the risk of blood
loss when taken with drugs to stop blood clots, for instance, aspirin. Utmost of the persons
who take this medication accept it well, though there is a likelihood that he or she might
experience different adverse effects. Certain of the shared side effects linked with this
medication include constipation or heartburn, nausea, and, vomiting (Maksimović &
Samardžić, 2018).
Polypharmacy is the simultaneous consumption of multiple medications by the
patient. It is of utmost common among elder individuals affecting about 40 percent of the
elder individuals living in their households (Kaufman, 2011). As Mr. Di Lorenzo has been
different from other medications, there is a likelihood that he might experience polypharmacy
problems. Osteoarthritis is the progressively prevalent illness with the occurrence rate that
upsurges with age. Inappropriately, most usually prescribed medication for delivering the
indicative relief cause progress important GI ulceration. For instance, in the case of Mr. Di
Lorenzo, taking aspirin might cause intestinal impairment. Indications caused through
polypharmacy comprises tiredness, drowsiness, abridged alertness, constipation, diarrhea,
high tremors, problems of visual and auditory functions, anxiety, and faintness (Rodrigues &
Oliveira, 2016).
Assessment and services
Australian government initiated a program called Myagedcare for older persons with
osteoarthritis and supports for different health issues. Myagedcare supports the separate to
find health care providers and facilities for their health problems. Patients like Mr. Di
Lorenzo are recommended to follow the steps stated in the MyAgedCare website. The initial

OA 5
step is to study what kind of facilities he requires, and what facilities are obtainable (Care,
2015). In another step, Mr. Di Lorenzo will get knowledge about the application for
assessment. Another step he will be able to search a provider, and in the end stage, he will be
capable to get dissimilar facilities such as commonwealth home provision programs, home
care programs, housing respite, transition upkeep, temporary restorative upkeep, and aged
care households. The diseased person can also receive the info about different facilities like
self-management programs, public programs, data and education sessions, and support
groups for osteoarthritis Mr. Di Lorenzo can receive health care services on arthritis Australia
portal (Arthritis Australia, 2017).
Aged care system provides disability provision for persons with osteoarthritis who are
at least 65-year-old. Recent programs of Australian government organizations in the extent of
incapacity provide a possibility to meaningfully enhance the inclusion, provision and
different chances for individuals with OA (Australian Institute of Health and Welfare, 2019).
This encompasses the involvement of the National incapacity insurance program and the state
and countrywide programs under the nationwide disability strategy. Osteoarthritis related
disability gets reasonable and proper provision, help for the family carers, to assist them in
handling patient’s quality of life (Ackerman et al., 2019).
Mr. Di Lorenzo also requires a valuation to be commenced like Aged Care
Assessment Team (ACAT). It involves therapeutic, nursing, and allied health care providers
to assess the bodily, psychological, medical, healing, cultural, and societal requirements
(Ball, 2018). A nurse must assess Mr. Di Lorenzo for both physical and mental health. the
first task must be performed by the health care team is asking the patient history, clarify the
medical practice to Mr. Di Lorenzo, and conduct the evaluation process. As Mr. Di Lorenzo
developed both mental and bodily difficulties, this assessment will support in the treatment
procedure. Arthritis Australia is a well-recognized organization established in 1949 and

OA 6
become a main body in the country for persons with arthritis living different states like the
ACT, NSW, Northern Territory of Australia, Queensland, South Australia, and Tasmania
(Arthritis Australia, 2017). There are different peer support groups supporting persons with
OA, for example, the Ararat Arthritis Provision group, the Ballarat Arthritis peer provision
group, Bendigo arthritis club inc, etc. (Australian Institute of Health and Welfare, 2019).
Communication
healthcare professionals must share complete info with Mr. Di Lorenzo about his
health problem, impact of the illness, bereavement, and superannuation on his family and to
self-care approaches at his house. Mr. Di Lorenzo and his family must be providing proper
info about problems like pain, difficulties in performing everyday life works. Individuals
living with this health issue often experience depression and stress (Al-Omari et al., 2019).
Consequently, Jack and his relatives must be educated about handling such complications.
Patient fall is recognised as one of the chief risks linked with the OA. In case of Mr. Di
Lorenzo there is a great risk of fall due to his age and he is unable to accomplish normal
actions like walking and going upstairs. Thus, the family members must be informed to
support the patient in handling daily happenings. Bereavement and societal isolation
frequently experienced by the individuals which can additionally deteriorate the illness
(Chou, et al., 2019). This must be discussed with Mr. Di Lorenzo.
Conclusion
In conclusion, the healthcare professional must share comprehensive information with
Mr. Di Lorenzo about his health problem, the influence of the illness, bereavement, and
retirement on his families and to self-care approaches at his home. Mr. Di Lorenzo and his
family must be must have appropriate information about symptoms like pain, problems in
carrying out daily life activities. Diseased persons living with osteoarthritis frequently
experience depression and stress-related problems. Thus, Mr. Di Lorenzo and his family must

OA 7
be educated about the management of such problems. Mr. Di Lorenzo may also experience
patient fall which is the main risks comes with osteoarthritis There is an increased risk of fall
in case of Mr. Di Lorenzo as he is aged and incapable to perform usual activities like walking
in the garden and going upstairs. Thus, his carers should be knowledgeable to support the
patient in performing daily work. Bereavement and social isolation often experienced by the
OA patients which can further deteriorate the condition. After the death of his wife, there is a
great probability that he experienced stress. After discharge from the hospital, he will be
recommended to self-manage OA at his home. Jack has been working for many years, now
taking retirement on his family might develop social isolation issues that hinder the treatment
process. Therefore, Jack and his family should be educated to engage him in social activities.
Self-care programs can be applied in the case of Mr. Di Lorenzo. Self-care or self-
management teaching initiatives are behavioral methods designed to encourage persons
with long-lasting illness to be a role model in the management procedure of their health issue.
These specific initiatives aim to improve outcomes for individuals with OA through
supporting, not relieving, medical upkeep. The content of education used to help the patient
learning about their disorder and to elucidate how they can easily manage different signs and
symptoms varies. The self-care programs will encourage Mr. Di Lorenzo to learn certain
simple methods to ease the OA symptoms. The health care providers must encourage Mr. Di
Lorenzo to have a balanced diet daily. As Jack is suffering from several health problems, a
healthy diet will help him to manage his symptoms of OA. Different Investigations
designates that dissimilar nutrients like vitamin c and omega-three fatty acids are beneficial
in easing OA symptoms. As Mr. Di Lorenzo has been taking some complimentary drugs
without the recommendation of a doctor, he must be educated to discuss with his GP about
these drugs to avoid further complications.

OA 8
In conclusion, OA is the bone issue characterized by the breakdown and loss of bone
tissues or cartilage present between the patient’s bones and joints. There are various risk
factors linked with the bone issue (OA) for example family history, being woman, old age,
and overweightness. The epidemiological data showed that one in eleven Australian
experience OA for which around 3.5 million dollars has been spent annually to provide
effective care to OA patients. Some of the symptoms of this health issue include pain, joints
stiffness, tenderness, spurs of bone, tissue swelling, etc. The contributing factors of OA are
being old, untreated joint impairments, and metabolic illnesses. Taking additional medication
deprived of consultation might also worsen the condition. In the case of Mr. Di Lorenzo fish
oil medicines, willow bark tea, and glucosamine drug was provided by his family member.
These drugs can interact with aspirin and cause different other health problems.
Polypharmacy problems might cause weariness, reduced attentiveness, constipation, etc.
Suitable support groups can assist Mr. Di Lorenzo to get valuation services. The nationwide
disability assurance scheme provisions OA persons through insuring them. ACAT can be
allocated to assess the diseased person for physical, psychological and societal aspects. A
supportive agency named Arthritis Australia is at work for individuals with OA. Mr. Di
Lorenzo must be informed with complete information about his health issues and treatment
process that will be used to manage OA, impacts of the disease, bereavement, and
superannuation on his relatives and to self-care methods at his living place.

OA 9
References
Ackerman, I. N., Bohensky, M. A., Zomer, E., Tacey, M., Gorelik, A., Brand, C. A., & De
Steiger, R. (2019). The projected burden of primary total knee and hip replacement
for osteoarthritis in Australia to the year 2030. BMC musculoskeletal disorders, 20(1),
90.
Al-Omari, B., Bate, A., & McMeekin, P. (2019). The Shared Decision for Osteoarthritis
Treatments. Orthopedic Research Online Journal, 5(5), OPROJ-000625.
Antonelli, M. C., & Starz, T. W. (2012). Assessing for risk and progression of osteoarthritis:
the nurse's role. AJN The American Journal of Nursing, 112(3), S26-S31.
Arthritis Australia (2017). Osteoarthritis. Retrieved from:
https://arthritisaustralia.com.au/types-of-arthritis/osteoarthritis/
Australian Institute of Health and Welfare (2019). Osteoarthritis. Retrieved from:
https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis/
contents/what-is-osteoarthritis
Ball, T. (2018). Rehabilitation for the Older Patient. In Geriatric Medicine (pp. 181-192).
Springer, Singapore.
Berenbaum, F., Eymard, F., & Houard, X. (2013). Osteoarthritis, inflammation, and obesity.
Current opinion in rheumatology, 25(1), 114-118.
Brembo, E. A., Kapstad, H., Eide, T., Månsson, L., Van Dulmen, S., & Eide, H. (2016).
Patient information and emotional needs across the hip osteoarthritis continuum: a
qualitative study. BMC health services research, 16(1), 88.
Care, M. A. (2015). My Aged Care changes. Australian Medicine, 27, 11.

OA 10
Chen, D., Shen, J., Zhao, W., Wang, T., Han, L., Hamilton, J. L., & Im, H. J. (2017).
Osteoarthritis: toward a comprehensive understanding of pathological
mechanism. Bone research, 5(1), 1-13.
Chou, L., Ellis, L., Papandony, M., Seneviwickrama, K. M. D., Cicuttini, F. M., Sullivan,
K., ... & Wluka, A. E. (2018). Patients’ perceived needs of osteoarthritis health
information: a systematic scoping review. PloS one, 13(4).
Evaniew, A. L., & Evaniew, N. (2017). Knee osteoarthritis: Therapeutic alternatives in
primary care. World journal of orthopedics, 8(2), 187.
Hill, C. L., March, L. M., Aitken, D., Lester, S. E., Battersby, R., Hynes, K., ... & Jones, G.
(2016). Fish oil in knee osteoarthritis: a randomized clinical trial of low dose versus
high dose. Annals of the rheumatic diseases, 75(1), 23-29.
Kaufman, G. (2011). Polypharmacy in older adults. Nursing standard, 25(38), 49-57.
Maksimović, Z., & Samardžić, S. (2018). Herbal Medicinal Products in the Treatment of
Osteoarthritis. In Osteoarthritis Biomarkers and Treatments. IntechOpen.
Nakamura, H. (2011). Application of glucosamine on human disease—
Osteoarthritis. Carbohydrate polymers, 84(2), 835-839.
Rodrigues, M. C. S., & Oliveira, C. D. (2016). Drug-drug interactions and adverse drug
reactions in polypharmacy among older adults: an integrative review. Revista Latino-
Americana de enfermagem, 24.
Shara, M., & Stohs, S. J. (2015). Efficacy and safety of white willow bark (Salix alba)
extracts. Phytotherapy Research, 29(8), 1112-1116.

OA 11