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Nursing IV: Test 3 > Rheumatoid Arthritis > Flashcards

Rheumatoid Arthritis Flashcards

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0
Q

Rheumatoid Arthritis

-Risk Factors

A
  1. Women Between the ages of 40-60 yrs
  2. Family Hx
  3. Heavy Smokers
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1
Q

Rheumatoid Arthritis

-Etiology

A
  1. Combination of:
    - Genetic, environmental, hormonal, and reproductive factors
    - Ebstein-Barr Virus T
  2. Long-term exposure to unidentified antigen causes immune response in genetically susceptible host
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2
Q

RA

-Characteristic Manifestations

A
  1. Characterized by remissions and exacerbations
  2. Tender, swollen, red, warm, “boggy” joints
  3. Symmetric inflammation
  4. Disease progresssion is fastest in 1st 6 years, then slows down
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3
Q

Rheumatoid Arthritis

-Systemic Manifestations (Extra-Articular)

A
  1. Fatigue
  2. Loss of appetite & Weight loss
  3. Nonspecific aching and stiffness
  4. Low grade fever
  5. Anemia resistant to iron therapy
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4
Q

Rheumatoid Arthritis

-Joint Manifestations

A
  1. Clients report Joint swelling, stiffness, warmth, tenderness & pain
  2. Proximal interphalangeal (PIP) & Metacarpophalangeal (MCP) joints of the fingers, wrists, knees, ankles and toes are most often involved
  3. Morning stiffness lasting >1hr
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5
Q

Rheumatoid Arthritis

-Swan-neck deformity

A
  1. Characterized by hyperextension of the PIP joints w/ compensatory flexion of the distal interphalangeal joints
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6
Q

RA

-Cause of Deformities

A
  1. Deformities are caused by the development of a PANNUS

- Pannus = longterm, severe proliferation of the synovial intimal layer

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7
Q

Rheumatoid Arthritis

-Extra-Articular Manifestations

A
  1. Rheumatoid Nodules in the
    - heart, lungs, intestinal tract, & dura
  2. Subcutaneous nodules
  3. Pleural effusion
  4. Vasculitis, pericarditis
  5. Splenomegaly
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8
Q

Rheumatoid Arthritis

-Effects on Perfusion

A
  1. Increased risk of CAD, MI & Death
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9
Q

Rheumatoid Arthritis

-Goals of Therapy

A
  1. Relive pain
  2. Reduce inflammation
  3. Slow or stop joint damage
  4. Improve well-being & ability to function
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10
Q

Rheumatoid Arthritis

-Diagnostic Tests

A
  1. Lab tests for Rheumatoid factors and ESR
    - usually elevated in RA
  2. CBC to ID anemia (wbc)
  3. Cyclic citrullinated peptide **
    - New test for early detection
  4. Synovial fluid Exam (shows inflammatory changes)
  5. X-ray
    - Most specific test.. doesn’t show many changes early in RA
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11
Q

Rheumatoid Arthritis

-Pharmacology

A
  1. Aspirin & NSAIDS
    - Help with Inflammation but NO EFFECT on disease progression
  2. Low-dose corticosteroids
    - Pain and inflammation relief. SLOW progression of RA
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12
Q

Corticosteroid

-PT Teaching

A
  1. Pt’s may experience weight gain
  2. Increase Blood sugar & decreases Immune response
  3. Long term use causes CUSHING SYNDROME
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13
Q

Rheumatoid Arthritis

-Anti-rheumatic Drugs

A
  1. Gold salts
    - Make patient very tired
  2. Antimalarial agents
    - Plaquenil - irreversible vision loss - check eyes every 3 months
  3. Sulfasalazine
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14
Q

Rheumatoid Arthritis

-Nursing Care for NSAIDS

A
  1. Monitor for bleeding, bruising unexpectedly

2. Stomach irritation

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15
Q

Rheumatoid Arthritis

-Corticosteroids Nursing Care

A
  1. Take it with food and the same time every day

2. Check blood sugar

16
Q

Rheumatoid Arthritis

-Immunosuppressants Nursing Care

A
  1. Everyone who is around you should have a flu shot
  2. Avoid people who are sick
  3. Avoid large crowds
17
Q

Rheumatoid Arthritis

-Nursing Care for Surgery and other RA procedures

A
  1. Watch for infection
  2. Treat pain
  3. Pt will have limited mobility
18
Q

Rheumatoid Arthritis

-Alternative Therapies

A
  1. Rest and Exercise
  2. Physical & Occupational therapy
  3. Heat and Cold
  4. Nutrition
19
Q

Rheumatoid Arthritis

-Nursing Care to Deal with Pain & Immobility

A
  1. Space out ADL’s to deal with fatigue
  2. Long periods of rest make immobility worse
  3. Treat acute and chronic pain
20
Q

RA

-Nursing Diagnosis

A
  1. Acute & Chronic Pain RT joint inflammation
  2. Fatigue RT chronic pain & complications
  3. Disturbed Body Image RT joint deformities
  4. Activity Intolerance RT chronic pain
21
Q

RA

-Nursing Implementation

A
  1. Promoting mobility
  2. Encouraging adequate nutrition
  3. Teach family and client about disease and its mgmt

Nursing IV: Test 3 (7 decks)

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