Transcript Rheumatoid Arthritis

Linda Akioyame, Laura Dunwell, Crystal Johnson,
Kathlyn, Millare, Christina Porter, Whitney Slater,
Trung Tu, Daryl Yann
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An autoimmune disorder
that occurs when the
immune system
mistakenly attacks its own
body tissues
Inflammation occurs in
the lining of the joints,
causing painful swelling
that can eventually result
in joint breakdown and
deformity
Typically affects the small
joints in the hands and
the feet
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Red, swollen, painful, and tender joints in a
symmetrical pattern
Rheumatoid nodules
Low-grade fever
Fatigue/Loss of energy
Lack of appetite
Sjogren’s syndrome (dry mouth and eyes)
Chest pain upon coughing or deep
breathing d/t inflammation of lung lining
Decreased white and red blood cells
Felty’s syndrome (enlarged spleen)
Vasculitis (blood vessel inflammation)
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Normal adult results should be negative
positive or increase can indicate a possible RA or other
connective tissue diseases.
› measures the presence of unusual antibodies of
immunoglobulins G (IgG) and M (IgM)
› Not all positive titers are specific of RA especially in
adults
A positive in this test can also be elevated in leukemia,
liver disease, and renal disease
Recent blood transfusion may affect result
High lipid levels may cause a false-positive on test
Nursing Interventions – explain procedure, monitor site
for bleeding, report abnormal findings
This test shows the presence of
inflammation in the body and the activity of
the disease
 Indications: Inflammation, rheumatoid
arthritis, acute and chronic infection,
rheumatoid/auto-immune infections
 Normal range for males is up to 15mm/hr,
and females up to 25mm/hr
 Nursing Interventions: explain procedure,
monitor site for bleeding, andreport
abnormal readings
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Interrupts the immune system that promotes inflammation
Can slow or stop the progression sending RA into remission
Not only does it decrease pain and swelling, but also
reduces damage to joints and can prevent long-term
disability
Do not use methotrexate if the person has a liver disease,
bone marrow disorder, blood cell disorder, pregnant,
alcoholism, or active infection or hepatitis
SIDE EFFECTS
• Abdominal pain
• Chills or fever
• Dizziness
• Hair loss
• Headache
• Light sensitivity
• Itching
• Liver problems
• Low blood counts
Help manage chronic pain, inflammation, and swelling
› Prostaglandins are released by damaged tissues
which trigger imflammation that results in pain and
swelling
› NSIADS b lock prostaglandins by blocking COX
enzymes specifically, COX-1 & COX-2 do not slow RA
progression
 Ex. Ibuprofen (Advil, Motrin)
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SIDE EFFECTS
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GI Bleeding
Hepatitis
Constipation
Dyspepsia
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Nausea/Vomiting
Abdominal
Discomfort
Headache
Teach techniques for relieving
pain and morning stiffness
including:
Scheduling NSAIDs at equal
intervals throughout the day
 Taking morning NSAID dose
with milk and crackers
approximately 30 minutes
before rising
 Performing ROM exercises in
shower or bathtub
 Applying local heat with
paraffin dip or compress;
using cold packs as needed
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Teach techniques to
minimize joint stress while
performing ADLs
 Provide Arthritis Foundation
literature and information
 Discuss ways to delegate
household tasks to other
family members
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Regular, moderate exercise reduces joint pain
and stiffness, builds strong muscle around the
joints, and increases flexibility and endurance.
Dealing with pain can be the hardest part of
having arthritis, but pain can be managed by
learning more about RA, treatments,
preventative measures, and alternative
remedies.
Optimal treatment for the disease involves a
combination of medications, rest, jointstrengthening exercises, joint protection, and
patient (and family) education.
Early treatment of rheumatoid arthritis results in
better outcomes.
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What is the normal ESR range present in
males and females with Rheumatoid
Arthritis?
There is no known cure for RA, but individuals can
reduce symptoms of the disease by:
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Medications
Rest
Oral Hygiene
Joint-strengthening exercises
Joint protection
Patient and Family Teaching
a)
b)
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d)
1,2,3,4,5,6
2,3,5,6
1,2,4,5,6
4,5,6
Carey, RC. (2006, Semptember 30). Rheumatoid arthritis. Retrieved
from http://www.labtestsonline.org/understanding/conditions/rh
eumatoid-2.html
Mayo Clinic. (2009, November 3). Rheumatoid arthritis. Retrieved
from http://www.mayoclinic.com/health/rheumatoidarthritis/DS00020
Shiel, W. C. (2009, April 08). Rheumatoid arthritis. Retrieved
from http://www.medicinenet.com/rheumatoid_arthritis/article.h
tm
Van Leeuween, AV. (2006). Laboratory and diagnostic tests with
nursing implication. PHILADELPHIA: F.A Davis Company.
(2009, November 30). Rheumatoid arthritis guide. Retrieved
from http://www.webmd.com/rheumatoidarthritis/guide/rheumatoid-arthritis-medications
(2009). Rheumatoid arthritis. Retrieved
from http://www.medicinenet.com/rheumatoid_arthritis_pictures
_slideshow/article.htm
(2009). Rheumatoid arthritis. Retrieved
from http://www.arthritis.org/disease-center.php?disease_id=31