Health Promotion and Maintenance Q 47
An older patient with osteoarthritis is preparing for discharge. Which of the following information is correct.
A. Increased physical activity and daily exercise will help decrease discomfort associated with the condition.
B. Joint pain will diminish after a full night of rest.
C. Nonsteroidal anti-inflammatory medications should be taken on an empty stomach.
D. Acetaminophen (Tylenol) is a more effective anti-inflammatory than ibuprofen (Motrin).
Correct Answer: A. Increased physical activity and daily exercise will help decrease discomfort associated with the condition.
Physical activity and daily exercise can help to improve movement and decrease pain in osteoarthritis. Exercise programs that combine both aerobic and resistance training have been shown to decrease pain and improve physical function in multiple trials and should be encouraged by physicians regularly.
Option B: Joint pain and stiffness are often at their worst during the early morning after several hours of decreased movement. Evidence shows that water-based activities can help relieve symptoms and improve joint function, hence consultation with a physical therapist is recommended. Further, many of these patients may benefit from a walking aid.
Option C: Ibuprofen is a strong anti-inflammatory, but should always be taken with food to avoid GI distress. NSAIDs are usually prescribed orally or topically and initially, should be started as needed rather than scheduled. Due to gastrointestinal toxicity, and renal and cardiovascular side effects, oral NSAIDs should be used very cautiously and with close monitoring long term.
Option D: Acetaminophen is a pain reliever, but does not have anti-inflammatory activity. Pharmacotherapy of OA involves oral, topical, and/or intra-articular options. Acetaminophen and oral NSAIDs are the most popular and affordable options for OA and are usually the initial choice of pharmacologic treatment.