Question

Describe the labs/assessment the nurse would be aware for with rational for patients diagnosed with Ankylosing Spondlyitis.

Answer 1

ANKYLOSING SPONDYLITIS

Ankylosing spondylitis is an inflammatory disease which effects the vertebrae to fuse. By making the spine less flexible and can result in a forward hunched posture

SYMPTOMS INCLUDE

• Uveitis
• Joint stiffness
• Inflammation

NURSING ASSESSMENT INCLUDES

• General assessment
• Premedical history
• Present medical history including
• Diagnosis based on the area, type, and progression of the pain.
• Blood test can be performed to rule out the conditions such as rheumatoid arthritis.

PHYSICAL ASSESMENT

In spine

There is a loss of lordosis due to para spinal muscle spasm

Check for

• increased thoracic kyphosis
• forward thrust of the neck; upright
• balance is maintained by hips
• knees slightly flexed in late stage these may become fixed deformities.

PAIN

• Ask weather patient noticed stiffness after a period of rest which is improving with movement.
• Ask about variation in pain during day and night
• Check for the inflammation of tendon of Achilles
• Check for Enteritis’s inflammation of the entheses, the sites where tendons or ligaments insert into the bone. It is also called enthesopathy

• Functional limits can be identified by giving functional tasks like reaching a cup of glass, reach all directions can be checked by taking the ball from the professional and the position have to be changed every time.
• Bending activities can be given to understand the limits of activity, WOLF motor assessment scale can be used for assessment of motor skills
• Rom of all the limbs- check for the limitation and note down all the ranges.
• Psychological examination with mini mental status examination can be taken.
• Monthly proper examination recommended with standardized tools (BASMI, BASDAI, BASFI)

OTHER DIAGNOSIS

Imaging Tests

• Radiographic features- fusion of radio iliac joints
• Bony ankylosis of lumbar, thoracic and sometimes cervical regions.