Exam 4: Rheumatoid Arthritis

Question 1

Rheumatoid arthritis

Answer 1

Chronic, systemic autoimmune inflammatory disorder

Symmetrical and bilateral attack of peripheral joints, surrounding tissues, blood vessels, muscles, tendons

Remissions and exacerbations

WBCs attack synovial tissue, thickened and inflammed

Question 2

Risk factors for RA

Answer 2

Females ages 30-6, increased incidence 60+
Hereditary (any autoimmune disorder)
Bacterial or viral infection
Smoking
Environmental cause

Question 3

Symptoms of RA

Answer 3

Fatigue
Anorexia
Joint pain
Morning stiffness and after inactivity
Joint redness and swelling
Low grade fever
Weight loss
Joint nodules
Joint deformities (late finding), ulnar deviation and swan neck/boutonnieres

Question 4

Diagnosis of RA

Answer 4

ANA
Rheumatoid factor
Anti-CCP antibodies
ESR
CBC
Artheocentesis: WBC and RF present
X-ray: Evaluate and monitor destruction progression

Question 5

Acute treatment of RA

Answer 5

Prednisone and NSAIDS

Question 6

Chronic treatment of RA

Answer 6

DMARDs: Slow progression of RA bone deformities, joint erosion, and organ damage

Immunosuppression helps with pain and inflammation

Question 7

Nursing interventions for RA

Answer 7

Maximize function and ROM and minimize pain
Encourage use of affected joints
Walking and exercise with rest periods
Adaptive devices
Safe environment
Sleep hygiene
Small frequent meals
Psychological support
Pain eval and management: Meds, heat or cold, massage, positioning

Question 8

Lab tests used to diagnose RA

Answer 8

ANA and ESR

Question 9

Exam finding for late stage RA

Answer 9

Ulnar deviation

Question 10

Prednisone teaching understanding

Answer 10

“I will report any leg swelling immediately”