Rheumatoid Arthritis Flashcards
1
Q
Rheumatoid Arthritis
A
- Chronic, systemic disease characterized by inflammation of connective tissue of the diarthodial (synovial) joints and related structures
- Peak 4th-5th decade
- Remissions and exacerbations
- Extraarticular manifestations can occur at any age
2
Q
Contributing Factors
A
- Unknown cause
- Possible: autoimmunity, genetic factures (incidence with human leukocyte antigen)
3
Q
Assessment
A
- Insidious
- Fatigue, anorexia, weight loss, generalized stiffness
- Joint symptoms: pain, stiffness, limitation in motion, signs of inflammation, bilateral and symmetric
- Extraarticular manifestations can affect every system in the body: rheumatoid nodules are most common
4
Q
Diagnostic Studies
A
- Rhematoid factor, CBC, ESR, ANA, Lupus cell
- Synovial fluid analysis
- X-rays non specific
5
Q
Etanercept (enbrel)
A
Antirheumatic agent
Binds tumor necrosis factor (TNF), which is involved in immune and inflammatory reactions. Biologic response modifier with immune suppressive action
Use: acute and chronic rhumatoid arthritis
Side Effects:
- Pancytopenia
- Upper resp. tract infections
- Local injection site reaction
- H/A
- Dizziness
- rhinitis
- Increased risk for malignancy
TNI:
- SC
- Rotate injection sites
- Must be given for prescribed time to be effective
- Use caution when driving
- Teach client to look for s/s of infection
6
Q
Methotrexate (MTX)
A
Folic acid antimetabolite
Interferes with folic acid metabolism, also had immunosuppresive action
Use: used in the treatment of a variety of cancers and RA
Side Effects: pulmonary fibrosis, anemia, thrombocytopenia, leukopenia, anorexia, liver toxicity, nausea, stomatitis, vomiting
Nursing Implications:
- Monitor pulmonary function
- Monitor for symptoms of bleeding/infection
- teach client to watch for s/s of infection/bleeding
- instruct to empty stomach as any food may delay absorption
- Discourage alcohol use
- Advise to avoid sun
