Rheumatoid arthritis Flashcards
what is RA?
autoimmune disorder that originates in the synovial tissue that breaks down collagen leads to the edema which causes the destruction of cartilage and erosion of the bone
can be caused by smoking and genetics
clinical manifestations of RA
symmetric joint pain, swelling, warmth, erythema, lack of function
palpitation of joint reveals spongy/boggy tissue
fluid can be aspirated from the joint
characteristics begin in the small joints and progress to shoulders hips elbows ankle spine and TMJ
Symptoms of RA
onset is acute bilateral and symmetric
immobility of joints
hand deformities (swan neck)
raynauds
nontender and movable nodules (back of arms and feet)
other symptoms: arteritis, neuropathy, pericarditis, splenomegaly, Sjogen’s syndrome, dry eyes, mouth, vagina, secondary to osteoporosis hyperlipidemia
rheumatoid factor is present in
80% of RA patients
labs with RA
elevated ESR/CRP
decreased RBC and c4
positive ANA
what are DMARD drugs?
drugs that attempt to slow disease process and relieve more severe symptoms in an attempt to slow or stop progression or psoriatic arthritis
DMARD medications include
antimalarial agents
antibiotics
sulfonamide
biologic response modifiers
cytotoxic medications, methotrexate and lefunomiade
monitor kidney and liver functions can have nasty side effects
nursing management of someone with ra for mobility and pain
morning stiffness- hot shower pain in the hands- heated parrafin edema- cold therapy encourage physical activity mobility exercises
for pain flare ups of ra
prendisone, 7 days or so, taper, change in DMARD regime
client teaching for RA
maximize functional activity minimize pain monitor skin closely converse energy (space out activities, take rests, hot or cold) coping stragities routine health screening
other client teaching for RA
referrals for pt and ot provide information for support organizations use of assistive devices medication regimine monitor medication effectivness
signs and symptoms that need to be reported immediately
fever, infection, pain on substernal area of the chest, pain upon substernal area of the chest
therapeutic procedures for RA
total joint arthroplasties
plasmapheresis
plasmapherisis for RA
removes circulating antibodies from plasma decreasing attacks
total joint arthroplasty
surgical repair and replacement of a joint may be done for a severely deformed joint that has not responded to treatment
