NUR-631 Topic 13 DQ 2 • Online Nursing Essays

Sample Answer for NUR-631 Topic 13 DQ 2 Included After Question

Answer both of the following questions for your discussion response using the “Discussion Forum Sample.” 

Both osteoarthritis and rheumatoid arthritis present with several of the same manifestations, such as joint pain and stiffness. How do the two disorders differ? 

A child born with osteogenesis imperfecta is at risk for pathological fractures. Explain the pathophysiology of this disorder and the associated risk factors. 

A Sample Answer For the Assignment: NUR-631 Topic 13 DQ 2

Title: NUR-631 Topic 13 DQ 2

DQ RESPONSE 

MH 

Both osteoarthritis and rheumatoid arthritis present with several of the same manifestations, such as joint pain and stiffness. How do the two disorders differ? 

Osteoarthritis is characterized by local areas of articular cartilage damage causing bone-to-bone connection by enzymatic destruction clinical evidence of OA is seen during the fifth or sixth decade of life. In addition, primary OA is idiopathic, progressive, not related to predisposing events of injury ie trauma, strains, dislocation, fractures, long-term mechanical stress overuse, chronic disease of DM, ochronosis, and hemochromatosis, and if certain medications are responsible for OA are colchicine, indomethacin, and steroids then it’s classified as secondary osteoarthritis. Moreover, the most affected joints include the hip, knees, lower lumbar and cervical vertebrae, proximal and distal interphalangeal joints of the fingers diagnose as Heberden nodes and Bouchard nodes (McCance et al., 2018). 

             Classic inflammatory joint disease, arthritis is characterized by damage or destruction in the synovial membrane or articular cartilage and by systemic signs of inflammation of fever, leukocytosis, malaise, anorexia, hyperfibrinogenemia, infectious or noninfectious, infection by bacteria, mycoplasmas, viruses, fungi, or protozoa, invasion of these pathogens causes a systemic reaction that invades bones, heart, and blood vessels. Furthermore, noninfectious inflammatory joint diseases like gout where deposits of crystals of monosodium urate inside and around a joint can lead to rheumatoid arthritis. Rheumatoid arthritis (RA) is chronic systemic inflammation and the primary joint tissue to be affected is the synovial membrane which is attacked by several inflammatory enzymes the combination of autoimmune genetic involvement ie HLA is most significant in these patients. In evidence of the clinical evaluation between OA and RA, there is many similarities but RA is an autoimmune systemic there is bilateral joint on the hands, feet, and does tend to affect at any age and therefore classification criteria is used for RA by using categories due to its complexity this can categories the principal of RA if the score is equal or > 6 of 10 for RA vs OA where clinical evaluation can subjective assessment usually in one side asymmetric involvement of the large joints and degenerative(McCance et al., 2018). 

A child born with osteogenesis imperfecta is at risk for pathological fractures. Explain the pathophysiology of this disorder and the associated risk factors. 

Osteogenesis imperfecta (OI) or brittle bone disease in collagen-related dysplasia; synthesis of collagen type I multiple genetic defects and characterized by fragile bones, skin, abnormal teeth, and weak tendons; mutation in genes encoding α1 and α2 collagen chains in single base substitutions used to convert glycine in Gly-X-Y repeat to bulk amino acid and hampering the folding of the collagen chains into the triple helix presentation. In addition, Type I collagen in bones defines the bones that are predominantly affected, and clinical variability characterized by bone fragility, osteopenia, variable degrees of stature, and progressive skeletal deformities are among the complexity of risk factors. Moreover, OI with osteoporosis increases the rate of bone fractures, bony deformation, triangular facies, and vascular weakness like aortic aneurysm, which are all associated risk factors according to the newer classifications based on the model of inheritance, identifying the defective genes, or mechanisms (McCance et al., 2018). 

McCance, K. L., & Huether, S. E. (2018). Pathophysiology – e-book (8th ed.). Elsevier Health Sciences. 

REPLY 

Literature Review: Osteogenesis imperfecta is characterized by heightened bone fragility due to collagen mutations. The diagnosis primarily relies on the disorder’s clinical manifestations. Here, we present a scenario involving a male newborn born to a 33-year-old mother (who had given birth twice before) at the University of Nigeria Teaching Hospital in Enugu. Notably, there was no family history indicating OI. The neonate exhibited clinical indications resembling type II OI and experienced severe birth asphyxia. Despite a comprehensive collaborative treatment approach, the infant sadly passed away on the seventh day of life. 

Edelu, B., Ndu, I., Asinobi, I., Obu, H., & Adimora, G. (2014). Osteogenesis imperfecta: a case report and review of literature. Annals of medical and health sciences research, 4(Suppl 1), S1–S5. https://doi.org/10.4103/2141-9248.131683 

REPLY 

EG 

Both osteoarthritis and rheumatoid arthritis present with several of the same manifestations, such as joint pain and stiffness. How do the two disorders differ? 

Arthritis encompasses joint inflammation. RA and OA are two types of arthritis. RA and OA are distinct manifestations of the same illness that damage joints. OA is a degenerative joint disease, while RA is autoimmune. Autoimmune diseases like RA harm the body. In RA, your body assaults the soft lining around your joints like a virus or bacteria(Mohammed et al., 2020). This assault promotes joint fluid buildup. Fluid buildup causes swelling, joint discomfort, stiffness, and inflammation. 

 The most common form of arthritis, OA, is degenerative. OA damages joint cartilage. Bones rub due to cartilage wear. Exposing tiny nerves causes agony. Unlike RA, OA causes minimal inflammation. Women have greater arthritis than men(McCance et al., 2019). RA and OA are more common in elderly persons, but anybody can get them. RA is hereditary. If a parent, child, or sibling has it, your risk increases. Overweight, joint abnormalities, diabetes, gout, and joint trauma increase your risk of OA. Systemic diseases like RA can damage your lungs, heart, eyes, and joints. 

Low-grade fever, especially in youngsters, muscle aches, and weariness can indicate RA. Advanced RA patients may develop hard lumps near joints. Rheumatoid nodules can hurt. Small joints start RA. Finger joints may hurt, swell, and stiffen. RA can affect knees, shoulders, and ankles as it advances. OA patients rarely have symptoms. OA alone degenerates’ joints. Rheumatoid nodules are different from joint-area lumps. Bone spurs near joint margins are common in OA patients(Mohammed et al., 2020). 

Asymmetrical OA. One knee may hurt more than the other. Arthritis is incurable. Both methods of arthritis treatment aim to alleviate pain, symptoms, and joint damage. NSAIDs like ibuprofen reduce swelling and pain in both forms of arthritis(Mohammed et al., 2020). Because RA is an autoimmune condition, medications are administered to inhibit the immune system and limit antibody generation, reducing flare-ups and damage. Physical and occupational therapy increase mobility and everyday routines. Both conditions require exercise, weight management, and good living. 

A child born with osteogenesis imperfecta is at risk for pathological fractures. Explain the pathophysiology of this disorder and the associated risk factors. 

Mutations in the type I procollagen genes COL1A1 and COL1A2 cause osteogenesis imperfecta (OI), a bone fragility disorder. Ol is also called Lobstein disease, brittle-bone disease, blue-sclera syndrome, and fragile-bone disease. Skeletal dysplasia includes Ol (Deguchi et al., 2021). It is a connective tissue disorder that can cause blue sclerae, triangular facies, and macrocephaly. Hearing loss, Defective dentition, Barrel chest, Scoliosis, Limb abnormalities, Fractures, Joint laxity, Growth retardation. 

Ol is hereditary and incurable. The condition needs comprehensive treatment. Bone-building procedures are common. Orthotics fix loose joints and prevent increasing deformities and fractures (Deguchi et al., 2021). Walking aids, adapted wheelchairs, and home adaptation equipment are more critical for patient mobility and function. Surgery is still a key treatment, but only if it can improve function and the goals are clear. Bone, ligament, dentin, and sclera, which contain type 1 collagen, show pathologic alterations in Ol. Type 1 collagen is reduced. Mutations in type 1 collagen genes affect one of the two genes, causing 80% of Ol cases(McCance et al., 2019). 

Hereditary risk is greatest. If one parent has osteogenesis imperfecta, a child has a 50% chance. Most osteogenesis imperfecta cases are hereditary(McCance et al., 2019). Recessive inheritance passes rare forms. 35% of osteogenesis imperfecta children have no family history. Gene mutations cause this. Parents didn’t cause it. Brittle bone disease is treated to reduce its symptoms as there is no cure. Muscle and bone growth. Reduce fractures. Aligning bones. Musculoskeletal optimization. maximizing growth and health. 

References 

Deguchi, M., Tsuji, S., Katsura, D., Kasahara, K., Kimura, F., & Murakami, T. (2021). Current Overview of Osteogenesis Imperfecta. Medicina (Kaunas, Lithuania), 57(5), 464. https://doi.org/10.3390/medicina57050464 

McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2019). Pathophysiology: The biologic basis for disease in adults and children. Elsevier. 

Mohammed, A., Alshamarri, T., Adeyeye, T., Lazariu, V., McNutt, L. A., & Carpenter, D. O. (2020). A comparison of risk factors for osteo- and rheumatoid arthritis using NHANES data. Preventive medicine reports, 20, 101242. https://doi.org/10.1016/j.pmedr.2020.101242