Definition

• A chronic inflammatory disease of the spine that can result in fused vertebrae and rigid spine.

Etiology

• Unknown
• Genetic link

Pathophysiology

• Genetic link
• Ligaments supporting bones become calcified of filled with lime.
• Disease gradually progresses upward until the end of spine
• Spine become stiff
• The upper curve of the spine become more bent
• Muscle spasm occur

Signs and Symptoms

1. Lower back pain that is worse at night, in the morning or after inactivity.
2. Stiffness and limited motion in lower back pain.
3. Hip pain and stiffness.
4. Limited expansion of chest.
5. Limited range of motion, especially involving spine and hips.
6. Joint pain and joint swelling in the shoulders, knees, and ankles.
7. Neck pain
8. Heel pain
9. Chronic stooping to relieve symptoms.
10. Fatigue
11. Low grade fever
12. Loss of appetite
13. Weight loss
14. Eye inflammation

Assessment

1. White blood cells
2. Glucose content of synovial fluid decreased
3. X-ray
4. Synovial fluid analysis or culture and joint fluid.
5. Blood culture
6. RBC decrease
7. Physical examination
8. C-reactive protein test
9. Immunoglobulin electrophoresis
10. Creatinine clearance

Nursing Diagnoses

• Pain
• Impaired physical mobility
• Self-care deficit
• Fatigue
• Activity intolerance
• Potential for injury
• Knowledge defict
• Body image disturbances

Complications

1. The jaw about ten percent of people with spondylitis experienced inflammation of the jaw. This can be particularly debilitating causing difficulty in fully opening the mouth to eat.
2. Iritis or Anterior Uveitis (inflammation of the eye). About one third of people with spondylitis will experience inflammation of the eye atleast once.
3. Spinal rigidity
4. Paraspinal calcification
5. Respiratory complication

Nursing Interventions

1. Apply heat packs at the affected area.
2. Provide adequate rest.
3. Encourage to perform isometric exercises.
4. Provide the patient quiet environment.
5. Discuss the factors of his or her present condition.
6. Encourage diversional activities.
7. Provide foods that are low calories.
8. Promote safe physical environment and individual safety.
9. Encourage deep breathing exercises.
10. Use ambulatory devices.
11. Administer analgesics as ordered to control pain.
12. Schedule patient walking exercises activities.