Gina had been a sales manager for 31 years. Now that she has retired, she is starting to feel the pangs of long term standing when she was once working. Oftentimes, she feels pain on her knees and she could see redness and swelling on the same area. The same sensation started spreading towards her hips, her elbows, and shoulders. She went for a consultation, and after a series of laboratory tests, she was diagnosed with rheumatoid arthritis. Show
What is Rheumatoid Arthritis?Rheumatoid arthritis is classified as a diffuse connective tissue disease.
PathophysiologyThe pathophysiology of rheumatoid arthritis is brief and concise.
Statistics and IncidencesRheumatoid arthritis is common worldwide.
CausesDiffuse connective tissue diseases have unknown causes, but they are also thought to be the result of immunologic abnormalities.
Clinical ManifestationsClinical manifestations of RA vary, usually reflecting the stage and severity of tge disease.
ComplicationsMedications used for treating rheumatoid arthritis may cause serious and adverse side effects.
Assessment and Diagnostic FindingsSeveral factors contribute to the diagnosis of RA.
Medical ManagementMedical management is aligned with each phase of rheumatoid arthritis.
Pharmacologic TherapyThe drugs used in each phase of rheumatoid arthritis include: Early Rheumatoid Arthritis
Moderate, Erosive Rheumatoid Arthritis
Persistent, Erosive Rheumatoid Arthritis
Advanced, Unremitting Rheumatoid Arthritis
Surgical ManagementFor persistent, erosive RA, reconstructive surgery is often used.
Nursing ManagementNursing care of the patient with RA should follow a basic plan of care. Nursing AssessmentThe assessment of a patient with RA can contribute to its diagnosis.
Nursing DiagnosisBases on the assessment data, the major nursing diagnoses appropriate for the patient are:
Nursing Care Planning & GoalsMain Article: 6 Rheumatoid Arthritis Nursing Care Plans The major goals for a patient with RA are:
Nursing InterventionsThe patient with RA needs information about the disease to make self-management decisions and to cope with having a chronic disease. Relieving Pain and Discomfort
Reducing Fatigue
Increasing Mobility
Facilitating Self Care
Improving Body Image and Coping Skills
Monitoring and Managing Potential Complications
Teaching Points
Continuing Care
EvaluationExpected outcomes include:
Discharge and Home Care GuidelinesPatient teaching is an essential aspect of discharge and home care.
Documentation GuidelinesThe focus of documentation include:
Practice Quiz: Rheumatoid ArthritisHere are some practice questions for this study guide. Please visit our nursing test bank page for more NCLEX practice questions. 1. Gold sodium thiomalate is prescribed to a client with rheumatoid arthritis. Which of the following side effects indicates an overdosage of the medication? A. Flushing. 1. Answer: D. Metallic taste.
2. Adalimumab (Humira) is given to a client for the treatment of rheumatoid arthritis. Which of the following side effect is associated with the medication? A. Numbness. 2. Answer: A. Numbness.
3. A client has just been prescribed with Methotrexate(Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is to? A. Clay-colored
stool is a normal response of the treatment. 3. Answer: C. Strict hand washing.
4. Mr. Mc Princeton who is diagnosed with rheumatoid arthritis (RA) complains about joints that always hurt, saying, “I just feel like staying in bed all day.” Which discharge instruction would be aimed at maintaining as such function as possible? A. “Refrain from exercise because it only aggravates the disease process.” 4. Answer: D. “Promote aquatic (water) exercises to enhance joint mobility.”
5. The classic signs and symptoms of rheumatoid arthritis include which of the following? A. Pain on weight-bearing, rash and low-grade fever. 5. Answer: B. Joint swelling, joint stiffness in the morning and bilateral joint movement.
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